Pediatric blunt abdominal trauma in the emergency department: evidence-based management techniques.

Blunt abdominal trauma is the third most common cause of pediatric trauma deaths, but it is the most common unrecognized fatal injury. This issue discusses common mechanisms and injuries seen in children with blunt abdominal trauma and takes a closer look at current evaluation and management techniques. The main-stays of diagnostic evaluation include laboratory, sonography, and computed tomography studies. However, the routine use of these studies may not be necessary, and controversy exists as to which studies are beneficial and which are less valuable. The concern for radiation-induced malignancy has led to increased efforts to limit radiation exposure by decreasing the use of unnecessary computed tomography scans. The history and physical examination, combined with the mechanism of injury, should be used to develop a thoughtful and directed diagnostic workup.