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Abd-erRazik MA, Abdel Hamid MA, El-Shinawi M, Hirshon JM, El-Hariri HM, El-Setouhy M. Combination of Focused Assessment With Sonography for Trauma (FAST) Scan and Detection of Hematuria to Exclude Intra-abdominal Injuries Following Blunt Abdominal Trauma. Cureus 2023; 15:e34736. [PMID: 36909092 PMCID: PMC9997730 DOI: 10.7759/cureus.34736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
Background Blunt abdominal trauma (BAT) is the most common pattern of abdominal traumas. It may be associated with intra-abdominal injuries (IAIs). Exploratory laparotomies are only needed in a minority of patients after BAT. Methodology All BAT patients who presented to the El Demerdash Hospital of Ain Shams University, Cairo, Egypt during the study period were traced. Parameters including demographic data, focused assessment with sonography for trauma (FAST) scan, CT scan results, and hematuria were collected. The cohort was divided according to the CT scan results into two groups: patients with IAIs and patients without IAIs. Results Males represented 78.2% of the patients, and the mean age of the recruited patients was 32.1 ± 18 years. Road traffic accidents represented the main cause of trauma (58%). Patients with IAIs detected by CT scan represented 1.62%, and hematuria was detected in 88.9% of them. The specificity of FAST was 97.1%, and that of hematuria was 84.1%, and for the combination of both tests, the specificity was 99.3%. Conclusion IAIs after BAT can usually be excluded if both FAST and hematuria are negative, provided that the patient is stable.
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Affiliation(s)
| | | | - Mohamed El-Shinawi
- Department of General Surgery, Ain Shams University, Cairo, EGY
- Department of Surgery, Galala University, Suez, EGY
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Jon M Hirshon
- Department of Emergency Medicine/Community Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Hazem M El-Hariri
- Department of Community Medicine, National Research Centre, Cairo, EGY
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Jazan University, Jazan, SAU
- Department of Community, Environmental, and Occupational Medicine, Ain Shams University, Cairo, EGY
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Martin-Champetier A, Caujolle A, Bosdure E, Bresson V, Aschero A, Desvignes C, Colavolpe N, Pico H, Seiler C, Panuel M, Chaumoitre K, Petit P, Dabadie A. Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience. CHILD MALTREATMENT 2022; 27:209-217. [PMID: 34797202 DOI: 10.1177/10775595211054751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In France, the current recommendation is to perform a routine abdominopelvic ultrasound in any child under 2 years of age who is suspected to have been abused. We retrospectively studied the relevance of this practice in our center over the past fifteen years. This was a descriptive, retrospective study of all children under 2 years of age who had been subject to suspected abuse. Abdominal images and reports were reviewed and cross-referenced with possible clinical and biological signs. Four hundred and five children were included between 2006 and 2020, of whom 296 underwent abdominal imaging (2 initial abdominopelvic CT scans, 4 ultrasounds followed by CT scans, and 290 ultrasounds alone). Four examinations revealed traumatic abnormalities related to abuse. These four children all had clinical or biological anomalies. In the absence of clinical or biological signs, no imagery showed any abnormality related to abuse.
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Affiliation(s)
- Antoine Martin-Champetier
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Anaïs Caujolle
- Department of Pediatric Medicine, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Emmanuelle Bosdure
- Department of Pediatric Medicine, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Violaine Bresson
- Department of Pediatric Medicine, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Audrey Aschero
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Catherine Desvignes
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Nathalie Colavolpe
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Harmony Pico
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Charlotte Seiler
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
| | - Michel Panuel
- Department of Medical Imaging, Hôpital Nord, 36900APHM, Marseille, France
- UMR 7268 ADÉS, Faculté de Médecine de Marseille, 128791Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Kathia Chaumoitre
- Department of Medical Imaging, Hôpital Nord, 36900APHM, Marseille, France
- UMR 7268 ADÉS, Faculté de Médecine de Marseille, 128791Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Philippe Petit
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
- Équipe d'Accueil 3279-IFR 125, Faculté de Médecine de Marseille, 128791Aix-Marseille Université, Marseille, France
| | - Alexia Dabadie
- Department of Pediatric and Prenatal Radiology, Hôpital Timone enfants, 36900APHM, Marseille, France
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Non-accidental Trauma in Infants: a Review of Evidence-Based Strategies for Diagnosis, Management, and Prevention. CURRENT TRAUMA REPORTS 2022. [DOI: 10.1007/s40719-021-00221-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose of Review
To provide a resource for providers that may be involved in the diagnosis and management of infant non-accidental trauma (NAT).
Recent Findings
Infants are more likely to both suffer from physical abuse and die from their subsequent injuries. There are missed opportunities among providers for recognizing sentinel injuries. Minority children are overrepresented in the reporting of child maltreatment, and there is systemic bias in the evaluation and treatment of minority victims of child abuse.
Summary
Unfortunately, no single, primary preventative intervention has been conclusively shown to reduce the incidence of child maltreatment. Standardized algorithms for NAT screening have been shown to increase the bias-free utilization of NAT evaluations. Every healthcare provider that interacts with children has a responsibility to recognize warning signs of NAT, be able to initiate the evaluation for suspected NAT, and understand their role as a mandatory reporter.
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