Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
Pediatric Emergency Unit, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
Am J Emerg Med. 2014 Jul;32(7):697-9. doi: 10.1016/j.ajem.2014.04.024. Epub 2014 Apr 18.
Computed tomography (CT) has become an important tool for the diagnosis of intra-abdominal and chest injuries in patients with blunt trauma. The role of CT in conscious asymptomatic patients with a suspicious mechanism of injury remains controversial. This controversy intensifies in the management of pediatric blunt trauma patients, who are much more susceptible to radiation exposure. The objective of this study was to evaluate the role of abdominal and chest CT imaging in asymptomatic pediatric patients with a suspicious mechanism of injury.
Forty-two pediatric patients up to 15 years old were prospectively enrolled. All patients presented with a suspicious mechanism of blunt trauma and multisystem injury. They were neurologically intact and had no signs of injury to the abdomen or chest. Patients underwent CT imaging of the chest and abdomen as part of the initial evaluation.
Thirty-one patients (74%) had a normal CT scan. Two patients of 11 with an abnormal CT scan required a change in management and were referred for observation in the Intensive Care Unit. None of the patients required surgical intervention.
The routine use of CT in asymptomatic pediatric patients with a suspicious mechanism of blunt trauma injury is not justified.
计算机断层扫描（CT）已成为诊断钝性创伤患者腹部和胸部损伤的重要工具。对于有可疑损伤机制但意识清醒且无症状的患者，CT 的作用仍存在争议。这种争议在小儿钝性创伤患者的管理中更为激烈，因为他们更容易受到辐射暴露。本研究的目的是评估 CT 成像在有可疑损伤机制但无症状的小儿患者中的作用。
前瞻性纳入 42 名 15 岁以下的儿科患者。所有患者均有可疑的钝性创伤和多系统损伤。他们神经功能完整，腹部或胸部无损伤迹象。患者在初始评估中接受胸部和腹部 CT 成像。
31 名患者（74%）的 CT 扫描正常。2 名 11 岁的异常 CT 扫描患者需要改变治疗方案，并在重症监护病房进行观察。没有患者需要手术干预。
对于有可疑钝性创伤机制但无症状的儿科患者，常规使用 CT 检查是不合理的。
