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Is computed tomography necessary to determine liver injury in pediatric trauma patients with negative ultrasonography?

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Abdominal trauma is the third most common cause of all trauma-related deaths in children. Liver injury is the second most common, but the most fatal injury associated with abdomen trauma. Because the liver enzymes have high sensitivity and specificity, the use of tomography has been discussed for accurate diagnosis of liver injury.

Methods

Our study was based on retrospective analyses of hemodynamically stabil patients under the age of 18 who were admitted to the emergency department with blunt abdominal trauma.

Results

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher as a result of liver injury. In the patients whose AST and ALT levels were lower than 40 IU/L, no liver injury was observed in the contrast-enhanced computed tomography (CT). No liver injury was detected in the patients with AST levels lower than 100 IU/L. Liver injury was detected with contrast-enhanced CT in only one patient whose ALT level was lower than 100 IU/L, but ultrasonography initially detected liver injury in this patient.

Conclusions

According to our findings, abdominal CT may not be necessary to detect liver injury if the patient has ALT and AST levels below 100 IU/L with a negative abdominal USG at admission and during follow-up.

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Conflict of interest

The authors certify that they have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (e.g., employment, consultancies, stock ownership, and honoraria).

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Authors and Affiliations

  1. Department of Emergency Medicine, Zonguldak State Hospital, Zonguldak, Turkey

    U. Kaya, B. Işık & S. Abacıoğlu

  2. Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

    U. Y. Çavuş, K. Aydın & F. Büyükcam

  3. Department of Emergency Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey

    M. E. Karakılıç

  4. Department of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Turkey

    A. B. Erdem

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  1. U. Kaya
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Correspondence to F. Büyükcam.

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Kaya, U., Çavuş, U.Y., Karakılıç, M.E. et al. Is computed tomography necessary to determine liver injury in pediatric trauma patients with negative ultrasonography?. Eur J Trauma Emerg Surg 39, 641–646 (2013). https://doi.org/10.1007/s00068-013-0322-2

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  • DOI: https://doi.org/10.1007/s00068-013-0322-2

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