Comparison of computed tomography and ultrasonographic imaging in the assessment of blunt abdominal trauma in children

Abstract

Background: Computed tomography (CT) has become established in the assessment of paediatric blunt abdominal trauma. However, advances in diagnostic imaging necessitate reassessment of the role of available diagnostic modalities.

Methods: Experience at a paediatric teaching hospital over a 5-year period was reviewed, with direct comparison of CT against ultrasonographic imaging in 26 children presenting with acute blunt abdominal trauma.

Results: Intra-abdominal injury was diagnosed by CT in 23 of 24 patients compared with 21 on ultrasonography, although ultrasonography identified organ-specific injury in only 12 of 24 patients. CT was superior in the assessment of the multiply injured child, and identified spinal and pelvic injuries in three patients. CT augmented plain chest radiography in ten patients with associated thoracic injuries.

Conclusion: CT is the imaging modality of choice in children with severe abdominal trauma but ultrasonography is a reasonable technique to arouse diagnostic suspicion in less severe injuries or where CT is unavailable or delayed.