CT following blunt abdominal trauma in children

Guidelines for imaging children who have suffered major blunt trauma have been produced by a sub-group of the British Society of Paediatric Radiologists (BSPR). These were developed after it was recognised that children are ‘not just small adults’ and have different injury patterns. This is due to differences in relative anatomical proportions (for example, small children have a relatively larger head), an unfused skeleton and greater tissue elasticity, but more importantly children are more sensitive to the effects of ionising radiation (IR), with longer to live and develop radiation induced cancers.

Children presenting with major complex polytrauma should be imaged with a pan-body CT, but the recommendations suggest pre-assessment plain films of the cervical spine and chest when there is a low clinical suspicion for significant injury, to identify whether a cervical or thoracic CT is required. CT is always recommended as the first line imaging for potential abdominal injury.

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