PEM Source

Your source for all things Pediatric Emergency Medicine


Question: Trauma

(Click the link to comment and to vote – voting not working through email, sorry!)

An 11 year old girl was sitting with lap belt only in the back seat of a minivan involved in a motor vehicle accident where her car was rear-ended. She has a “seat belt sign,” or ecchymosis over her lower abdomen. Her CT abdomen with contrast is normal, but she continues to have tenderness to palpation. However, she states she is hungry.

What is the best management?

pemsou5_wp • May 29, 2018

Previous Post

Next Post


  1. Kelly May 30, 2018 - 12:51 am Reply

    B) Admit for serial exams. Seatbelt ecchymoses are associated with visceral and hollow viscus injuries, and the CT may be normal in a patient with a bowel perforation. Signs of peritonitis can develop over time, and patients with ongoing abdominal tenderness should be observed with serial exams. The hyperflexion injury associated with lapbelt-only sitting and seatbelt ecchymoses may result in Chance fracture, a horizontal spinous fracture through the vertebral body, but this would cause back pain.

Leave a Reply

Your email address will not be published / Required fields are marked *