Streck et al reported a clinical prediction rule for identifying a pediatric patient who is at very low risk of intra-abdominal injury after blunt abdominal trauma. This can help to identify a patient who may not need an abdominal CT exam. The authors are from Medical University of South Carolina Children's Hospital in Charleston.

Patient selection: age < 16 years with blunt abdominal trauma


Criteria for a very low risk of intra-abdominal injury - all of the following:

(1) absence of abdominal pain

(2) absence of abdominal wall trauma, tenderness or distension

(3) normal chest X-ray

(4) serum AST <= 200 U/L

(5) normal serum pancreatic enzymes (amylase, lipase)


In the study population 34% met all of the criteria. Less than 1% had an iintra-abdominal injury and none had an injury requiring an acute intervention.

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