Conservative versus surgical therapy of pediatric blunt abdominal trauma. How much surgery is needed for abdominal trauma?

Accidents are the leading cause of death in children and blunt abdominal trauma significantly contributes to the morbidity and mortality. Over the last decades a paradigm shift has occurred in therapy. Solid organ injuries can mostly be treated nonoperatively if the child is hemodynamically stable. How much surgery is necessary for blunt abdominal trauma in children? How early do pediatric surgeons need to be involved? The article reviews the current international literature. Most children with blunt abdominal trauma can be nonoperatively treated. If a surgical intervention is necessary, the indications are often vital and surgery needs to be carried out without any time delay. The injured child needs a specialized interdisciplinary pediatric trauma team which plans the diagnostic and therapeutic steps together. Every child with suspected blunt abdominal trauma needs to be transferred to a designated pediatric trauma center where the primary assessment and decision making are carried out together with a pediatric surgeon.