Outcomes of pediatric blunt liver and spleen injury in 1029 patients using the ATOMAC+ pediatric trauma research network guideline

Multi-center study of 1,029 pediatric patients with blunt liver and spleen injuries managed using ATOMAC+ protocol guidelines. Only 8.2% required surgical intervention, with children showing no initial bleeding signs remaining stable. Transfusion exceeding 40 mL/kg strongly predicted need for operative intervention.