Ultrasound Research Today is a free monthly online journal that collates and summarizes the latest research about Ultrasound, including details on screening, diagnosis, pregnancy, detection.

Physical examination as a reliable tool to predict intra-abdominal injuries in brain-injured children.

Miller D, Garza J, Tuggle D, Mantor C, Puffinbarger N

Department of Surgery, Section of Pediatric Surgery, The University of Oklahoma College of Medicine, 940 NE 13th St, Room 2403, Oklahoma City, OK 73104, USA.

BACKGROUND: Brain-injured children have been thought to have an unreliable abdominal examination. This study evaluates the reliability of physical examination in the prediction of intra-abdominal injury in brain-injured children. METHODS: Pediatric patients with a traumatic brain injury or Glasgow Coma Scale (GCS) <15 and intra-abdominal organ injuries were selected. Admission data were reviewed, and findings were tabulated. RESULTS: Fifty patients had an abnormal abdominal examination. Nineteen of 71 patients with head injury and intra-abdominal organ injuries required laparotomy. These 19 patients had abdominal tenderness, distention, abrasions, and/or a positive focused abdominal sonography for trauma (FAST) scan. Seven of 19 patients had a GCS of 3. Of the 12 patients requiring surgery with GSC 4 to 14, all patients had abnormal physical examinations. CONCLUSIONS: Patients who required an operation presented with an abnormal examination and/or a positive FAST. These data suggest that examination and/or FAST may reliably identify patients with intra-abdominal organ injuries in need of an operation.

Published 12 December 2006 in Am J Surg, 192(6): 738-42.
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