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Clinical Guideline

Updated APSA Blunt Liver/Spleen Injury Guidelines 2019

Topic overview

The 2019 APSA guidelines update evidence-based recommendations for nonoperative management of blunt liver and spleen injuries in children. Key updates address the limited utility of serial hemoglobin monitoring, the role of CT contrast blush in predicting intervention need, and refined bedrest protocols based on injury grade.

Key Takeaways

  • Repeat hemoglobin/hematocrit monitoring after blunt solid organ injury in children has limited clinical utility
  • Admission hematocrit is a key predictor for transfusion need in pediatric blunt trauma patients
  • CT contrast blush in pediatric hepatic/splenic injury does not automatically mandate intervention
  • APSA ATOMAC guidelines support non-operative management for most pediatric blunt liver and spleen injuries
  • Bedrest protocols for pediatric solid organ injury management have been prospectively validated

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How to cite: GlobalCastMD. Updated APSA Blunt Liver/Spleen Injury Guidelines 2019. GlobalCastMD Medical Library. https://library.globalcastmd.com/guideline/1848

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