The pace of signs and symptoms of blunt abdominal trauma to children.

The authors describe the types, signs, and symptoms of blunt abdominal injury. Record reviews of children <5 years old were carried out at a regional children's hospital or level 1 trauma center between 1994 and 1999. Recognized cases of child abuse, penetrating trauma, or children with an unavailable chart were excluded. The mean age was 38 months (n = 42; range 11-59). Motor vehicle trauma caused most of the injuries (72%); 64% had isolated solid organ, 14% isolated hollow viscous, and 21% both organ injuries. Multisystem trauma included closed head injury (29%) and fractures (43%). Scene reports documented that 80% of those assessed immediately had abdominal pain. Average time taken to arrive at the emergency department was 66 minutes (range 15-420). Hollow viscous perforations were symptomatic from onset. The overall mortality rate was 12%, related to multitrauma. Most children suffering unintentional blunt abdominal trauma have immediate and ongoing injury. Caretakers promptly seek emergency care, and solid organ injuries predominate. The series mortality was low compared with that for abusive abdominal injuries.