Study objectives: The purpose of this study was to characterize the utility of radiologic imaging and examination under anesthesia in female pediatric patients with isolated blunt straddle injuries.
Design: Retrospective review.
Setting: Single health care system with a children's hospital and level 1 pediatric trauma center.
Participants: Female patients aged 1-17 years with blunt straddle injuries from 2006 to 2018.
Interventions: None.
Main outcome measures: Radiologic imaging performed, number of patients requiring exam under anesthesia (EUA), number of injuries not identified in patients who did not undergo EUA.
Results: The study cohort included 83 patients. Of these, 11 (13%) had imaging performed. Thirty-four patients were managed as outpatients, 28 were discharged from the emergency department without need for intervention, and 49 patients were admitted. Of these, 48 (98%) went to the operating room for exam EUA. No occult injuries were identified on radiologic studies. Imaging was not associated with need for EUA. No missed injuries occurred in children who were not imaged. Two patients who were imaged returned for EUA following evolution of symptoms.
Conclusion: Radiologic imaging did not add diagnostic value for female pediatric patients with blunt straddle injuries. These data emphasize the importance of EUA with repair and advocates for minimization of radiologic imaging in this patient group.
Keywords: Exam under anesthesia; Pelvic imaging; Straddle injury; Urogenital trauma.
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