Emergency Department, Inpatient, and ICU Clinical Pathway for Children with Blunt Abdominal Solid Organ Injury
Solid Organ Injury Suspected
This pathway is intended to treat children who present to the Emergency Department with suspected solid organ injuries to the liver, spleen, or kidney.
- Major multiple trauma when the solid organ injury does not direct the patient’s plan of care
- Specific findings/Injuries:
- Pancreatic injuries
- Penetrating solid organ injury
- Significant medical comorbidities
Review of history, physical exam, labs, and imaging may help clinicians determine need for further diagnostic imaging.
Abdomen/Pelvis CT with IV Contrast is the preferred modality for hemodynamically stable children. The addition of PO contrast does not improve detection of intra-abdominal injury and should be avoided unless directed by the Trauma Surgical team.
Note: Evaluation, including threshold to image, may change if there is suspicion for inflicted injury. ED Physical Abuse Clinical Pathway
Contraindications to CT:
- Hemodynamic instability
- Injury requiring emergent procedures
- Obvious signs of peritonitis or free air on plain radiograph of the abdomen
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