Diagnostics and Management
- Reimaging in pediatric blunt spleen and liver injury.
- Notrica DM, Sussman BL, Garcia NM, Leys CM, Maxson RT, Bhatia A, Letton RW, Ponsky T, Lawson KA, Eubanks JW 3rd, Alder AC, Greenwell C, Ostlie DJ, Tuggle DW, St Peter SD.
- J Pediatr Surg. 2019 Feb;54(2):340-344.
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Rationale for inclusion: Secondary analysis of prospective multi-center data on pediatric patients who underwent successful non-operative management of blunt liver and splenic trauma. Of 534 such patients, only 3 patients of the 27 who underwent re-imaging had clinically relevant findings. These results confirm the current guidelines that recommend against routine re-imaging after successful non-operative management of blunt liver or splenic injury in pediatric patients.
CAVEAT: Secondary analysis. Median AAST grade was 3Citations - To review the number of citations for this landmark paper, visit Google Scholar.
- Computed Tomography Rates and Estimated Radiation-Associated Cancer Risk Among Injured Children Treated at Different Trauma Center Types
- Sathya C, Alali AS, Wales PW, Langer JC, Kenney BD, Burd RS, Nance ML, Nathens AB.
- Injury. 2019 Jan;50(1):142-148.
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Rationale for inclusion: Retrospective study including 130 U.S. trauma centers demonstrating that pediatric trauma patients are more likely to undergo CT scanning at adult and adult/pediatric trauma centers than at specialized pediatric trauma centers. This is particularly true for children with low injury severity, a trauma mechanism of "fall", and teenagers. Increased use of CT scans is not associated with better outcomes but with a significantly increased calculated radiation exposure and presumed cancer risk.
CAVEAT: Retrospective study in TQIP
Citations - To review the number of citations for this landmark paper, visit Google Scholar.