@article{ref1,
title="Computed tomographic imaging in the pediatric patient with a seatbelt sign: still not good enough",
journal="Journal of pediatric surgery",
year="2018",
author="Kopelman, Tammy R. and Jamshidi, Ramin and Pieri, Paola G. and Davis, Karole and Bogert, James and Vail, Sydney J. and Gridley, Daniel and Singer Pressman, Melissa A.",
volume="53",
number="2",
pages="357-361",
abstract="PURPOSE: Considering the improvements in CT over the past decade, this study aimed to determine whether CT can diagnose HVI in pediatric trauma patients with seatbelt signs (SBS). <br><br>METHODS: We retrospectively identified pediatric patients with SBS who had abdominopelvic CT performed on initial evaluation over 5 1/2years. Abnormal CT was defined by identification of any intra-abdominal abnormality possibly related to trauma. <br><br>RESULTS: One hundred twenty patients met inclusion criteria. CT was abnormal in 38/120 (32%) patients: 34 scans had evidence of HVI and 6 showed solid organ injury (SOI). Of the 34 with suspicion for HVI, 15 (44%) had small amounts of isolated pelvic free fluid as the only abnormal CT finding; none required intervention. Ultimately, 16/120 (13%) patients suffered HVI and underwent celiotomy. Three patients initially had a normal CT but required celiotomy for clinical deterioration within 20h of presentation. False negative CT rate was 3.6%. The sensitivity, specificity and accuracy of CT to diagnose significant HVI in the presence of SBS were 81%, 80%, and 80%, respectively. <br><br>CONCLUSIONS: Despite improvements in CT, pediatric patients with SBS may have HVI not evident on initial CT confirming the need to observation for delayed manifestation of HVI. LEVEL OF EVIDENCE: Level II Study of a Diagnostic Test.<br><br>Copyright © 2017 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2017.10.003",
url="http://dx.doi.org/10.1016/j.jpedsurg.2017.10.003"
}