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Diminishing Differences: Evolving Care for Blunt Solid Organ Injury in Children

Nicholas Yung

The management of pediatric blunt Solid Organ Injury (SOI) has evolved with time. Traditionally, abdominal injuries were managed operatively, but decades of evidence-based research and guidelines have led trauma centers to adopt nonoperative management as the primary strategy for pediatric blunt SOI. These guidelines have influenced Length Of Stay (LOS), operative management, ICU utilization, bed rest, and activity restrictions. As more centers adopt protocols to manage pediatric trauma, outcomes for children have improved. A majority of the improvement has occurred at adult trauma centers; however, our research demonstrates significant differences remain among adult and pediatric trauma centers. In this review, we comment on the evolution of care, its current state, and areas where improvements might be made to better ensure equal care for all children admitted with blunt SOI.