Taylor et al identified a group of findings on an abdominal CT scan of young children that indicate hypovolemic shock. This hypoperfusion complex can help identify a child who may require aggressive management. The authors are from Children's Hospital National Medical Center and George Washington University in Washington, D.C.


Patient selection: young child (typically < 2 years of age)


Hypovolemic complex:

(1) decreased caliber for the abdominal aorta, the inferior vena cava and other major blood vessels

(2) marked, diffuse dilatation of the intestine due to fluid accumulation

(3) abnormally intense contrast enhancement of the bowel wall, mesentery, kidneys and/or pancreas

(4) moderate to large collections of peritoneal fluid


Later authors include:

(5) hypoperfusion of the pancreas and spleen


The presence of the hypovolemic complex indicates a serious hemodynamic abnormality and a poor prognosis, even if the patient may appear initially to be stable.


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