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My Belly Hurts—And I Got Hit by the Hulk

Abdominal trauma in pediatric patients can result in a variety of serious pathologies including solid organ lacerations, hollow viscus injuries, and others. Physical findings can provide insight to specific injuries. Management of children with intra-abdominal injuries should be guided by clinical picture and hemodynamic status rather than imaging, although imaging and laboratory testing are still frequently a useful part of the workup. Most patients may be managed nonoperatively in the case of solid organ injury, although a somewhat higher proportion receive packed red blood cells. Hollow viscus injuries can be more difficult to diagnose, as there are no reliable modalities for detecting them. Overall, however, most children with abdominal trauma recover and do very well long-term.