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. 2006 Dec;192(6):738-42.
doi: 10.1016/j.amjsurg.2006.08.036.

Physical examination as a reliable tool to predict intra-abdominal injuries in brain-injured children

Douglas Miller  1 , Jennifer Garza, David Tuggle, Cameron Mantor, Nikola Puffinbarger
Affiliations

Physical examination as a reliable tool to predict intra-abdominal injuries in brain-injured children

Douglas Miller et al. Am J Surg. 2006 Dec.

Abstract

Background: Brain-injured children have been thought to have an unreliable abdominal examination. This study evaluates the reliability of physical examination in the prediction of intra-abdominal injury in brain-injured children.

Methods: Pediatric patients with a traumatic brain injury or Glasgow Coma Scale (GCS) <15 and intra-abdominal organ injuries were selected. Admission data were reviewed, and findings were tabulated.

Results: Fifty patients had an abnormal abdominal examination. Nineteen of 71 patients with head injury and intra-abdominal organ injuries required laparotomy. These 19 patients had abdominal tenderness, distention, abrasions, and/or a positive focused abdominal sonography for trauma (FAST) scan. Seven of 19 patients had a GCS of 3. Of the 12 patients requiring surgery with GSC 4 to 14, all patients had abnormal physical examinations.

Conclusions: Patients who required an operation presented with an abnormal examination and/or a positive FAST. These data suggest that examination and/or FAST may reliably identify patients with intra-abdominal organ injuries in need of an operation.

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