ABSTRACT
Spleen and liver injuries are most commonly caused by blunt trauma. Among the solid organs, the spleen is the most frequently injured in blunt abdominal trauma, followed by the liver. Patients may present with abdominal pain, tenderness, bruising, tachycardia and hypotension. Diaphragmatic injuries are most commonly due to penetrating thoracoabdominal trauma. The presence of the nasogastric tube in the chest strongly suggests herniation of the stomach through a diaphragmatic defect. Computed tomography scan of the abdomen and pelvis is the gold standard for the radiological evaluation of abdominal trauma in the haemodynamically stable child. Intravenous contrast is essential for accurate delineation of solid-organ injury. Although the focused assessment sonography in trauma exam is useful for detection of free fluid in the abdomen or pelvis, its usefulness is limited in children since the majority of abdominal trauma in children is managed non-operatively and free fluid alone is not an indication for surgery.
