TY - CHAP M1 - Book, Section TI - Abdominal Trauma A1 - Stoffan, Alex A1 - Mooney, David P. A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. PY - 2014 T2 - Operative Pediatric Surgery, 2e AB - Most solid organ injuries can and should be managed nonoperatively.Laparotomy is still indicated for hemodynamic instability or peritonitis.Diaphragmatic injuries, once diagnosed, are often associated with thoracic and abdominal injuries, and should be explored and repaired from the abdomen.Splenorrhaphy remains the surgery of choice for unstable patients with splenic injury.Angioembolization may supplant operation for hemodynamically stable patients with persistent hemorrhage.Exploration for liver injury is rarely necessary, though some patients may require later interventional procedures for complications.Gastric injury is uncommon, though it may occur more often in children than in adults, and usually occurs along the greater curvature.The management of pancreatic ductal injury remains controversial: nonoperative, resection, or drainage.The duodenum is more exposed and more prone to injury in pediatric patients.Intestinal injuries are best diagnosed on physical examination, and therapeutic delay of less than 24 hours only mildly increases morbidity. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/18 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1100438452 ER -