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.”