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March 1985

Radiological Case of the Month

Author Affiliations

From the Departments of Pediatrics (Dr Weinberg) and Radiology (Dr Beam), Valley Childrens Hospital, Fresno, Calif.

Am J Dis Child. 1985;139(3):317-318. doi:10.1001/archpedi.1985.02140050111037

A 10-year-old boy was accidentally struck in the upper abdomen during a soccer game. He felt immediate severe pain and went home. The pain became intermittent, he vomited, and then his condition improved. The pain recurred and prompted medical attention eight to ten hours after the trauma. The patient's abdomen was tender and there was no peristalsis. The hemoglobin level was normal. A complete blood cell count showed a slightly elevated white blood cell count with a shift to the left. An abdominal roentgenogram was obtained (Figure).

Denouement and Discussion 

Pneumoretroperitoneum Following Blunt Abdominal Trauma 

Anteroposterior roentgenogram of supine abdomen showing retroperitoneal air outlining kidneys and psoas muscles.  The probability of intra-abdominal injury in the severely traumatized child needs little emphasis. However, intra-abdominal injury from minor accidents or incidental abdominal trauma is perhaps not fully appreciated. Examination of children for seemingly minor blunt abdominal trauma occurs frequently in the