ABSTRACT
Nearly half a century later, the standard treatment of hemodynamically stable children with splenic injury is non-operative, and this concept has now been successfully applied to most blunt injuries of the liver, kidney, and pancreas. This chapter focuses on the more common blunt injuries of the spleen, liver, duodenum, pancreas, and kidney. The spleen and liver are the organs most commonly injured in blunt abdominal trauma, with each accounting for one-third of injuries. Although occasionally reported in the literature, pancreaticoduodenectomy should be reserved for the most severe injuries to the duodenum and pancreas when the common blood supply is destroyed and any possibility of reconstruction is impossible. Injuries to the pancreas are slightly more common than duodenal injuries, with estimated ranges from 3% to 12% in children sustaining blunt abdominal trauma. Renal injuries in children are often caused by high-energy impact associated with motor vehicle accidents or other serious abdominal trauma.
