La prise en charge des traumatismes abdominaux de l’enfant

Abstract

Management of abdominal trauma in children has considerably changed over the last fifteen years. This is mainly due to advances in imaging techniques combined with a more conservative approach. Non-surgical management is frequently prefered with close clinical and biological surveillance, in addition to comprehensive imaging evaluation. The imaging work up must be adapted to this conservative approach. The increasing availability of helical CT technology and Doppler US imaging can be used to advantage in the evaluation of these patients. Euratom Directive 97-43 identifies children as a particular subgroup of patients with regards to exposure to ionizing radiation thus requiring us to reconsider the routine use of CT in this patient subpopulation and promoting the use of alternate imaging techniques. Based on a review of the literature as well as our own experience, where we currently favor US with selective use of CT, the advantages and pitfalls of each imaging technique will be reviewed. Ultimately, the imaging protocol for each patient should be based on availability, expertise, and individual clinical setting.