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 21 May 2018

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News

Physical examination reliably predicts intra-abdominal injuries in brain-injured children

This month's American Journal of Surgery suggests that examination reliably identifies brain-injured children with intra-abdominal organ injuries in need of an operation.

News image

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Brain-injured children have been thought to have an unreliable abdominal examination.

Dr David Tuggle and colleagues from Oklahoma evaluated the reliability of physical examination in the prediction of intra-abdominal injury in brain-injured children.

Pediatric patients with a traumatic brain injury or Glasgow Coma Scale less than 15 and intra-abdominal organ injuries were selected.

Admission data were reviewed, and findings were tabulated.

The research team reported that 50 patients had an abnormal abdominal examination.

7 of 19 patients had a Glasgow Coma Scale of 3
American Journal of Surgery

The team noted that 19 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 scan.

The researchers observed that 7 of 19 patients had a Glasgow Coma Scale of 3.All of the 12 patients requiring surgery with Glasgow Coma Score 4 to 14 had abnormal physical examinations.

Dr Tuggle's team concludes, “Patients who required an operation presented with an abnormal examination and/or a positive focused abdominal sonography for trauma scan.”

“These data suggest that examination and/or focused abdominal sonography for trauma may reliably identify patients with intra-abdominal organ injuries in need of an operation.”

Am J Surg 2006: 192(6): 738-42
15 December 2006

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