CONTRAST-ENHANCED ULTRASOUND IN PEDIATRIC ABDOMINAL TRAUMA

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Abstract Introduction Evaluation of the use of contrast-enhanced ultrasound (CEUS) in patients with abdominal trauma. Methods Retrospective study of patients with grade III or higher abdominal trauma, according to the American Association of Surgical Association (AAST) severity scale. All patients underwent an initial CT scan, mode B ultrasound before discharge and a second-generation contrast-enhanced ultrasound (CEUS) one month after the trauma (contrast dose=0.03 ml/kg). Results From January 2017 to December 2021, a total of 36 patients (2–15 years) with abdominal trauma were collected. 18 hepatic, 8 splenic, 8 renal and 2 pancreatic traumas. Of these, 8 patients required urgent embolization due to active bleeding or pseudoaneurysm and 1 patient required urgent surgical intervention. CEUS at 1 month showed: complete resolution in 22 patients, 2 residual hematomas, 1 patient with urinoma and devascularized area, 3 pseudoaneurysms, 7 with persistence of lacerations resolved at 2 weeks and 1 patient with 2 pancreatic cysts. Conclusions CEUS allows evaluation of parenchymal injuries of abdominal organs, as well as the presence of residual hematomas, active bleeding, pseudoaneurysms, urinomas and/or devascularized areas, therefore, it can be a useful tool for follow-up and monitoring of abdominal trauma. The absence of irradiation and its great accessibility allow it to be repeated as often as desired; and the confirmation of resolution enables an earlier return to daily life.

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