CT of blunt abdominal trauma in childhood

Computed tomography (CT) was performed on 23 children who had sustained moderate or severe blunt abdominal trauma. The major advantages of CT over excretory urography, sonography, and radionuclide imaging include superior anatomic detail and ability to visualize all organs, the peritoneal cavity, and retroperitoneum simultaneously. In suspected renal injury, CT best defines the extent of parenchymal injury and provides an easy method for accurate follow-up when conservative management is elected. Angiography is necessary for direct demonstration of vascular injury, for demonstration of active bleeding, and in therapeutic embolization of active bleeding sites. CT seems well suited to evaluation of the liver and retroperitoneum. Evaluation of the spleen has been satisfactory, but may be less accurate because of potential pitfalls. Duodenal hematomas are best evaluated by the upper gastrointestinal series. For CT scanning of the traumatized child to be of maximum value, intravenous contrast enhancement and meticulous attention to technique is necessary.