ArticleScandinavian journal of trauma, resuscitation and emergency medicine2016
Posttraumatic levels of liver enzymes can reduce the need for CT in children: a retrospective cohort study.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 13 citations in OpenAlex.
- Evaluation of Pediatric Patients with Blunt Abdominal Trauma: A Systematic Review, Meta-Analysis, and Practice Management Recommendations.Journal of the American College of Emergency Physicians open · 2026Article
- Macrophage-augmented organoids recapitulate the complex pathophysiology of viral diseases and enable development of multitarget therapeutics.Nature biomedical engineering · 2025Article
- Predicting and grading liver injury in the absence of computed tomographic imaging.Journal of family medicine and primary care · 2023Article
- Combination of liver enzymes, amylase and abdominal ultrasound tests have acceptable diagnostic values as an alternative test for abdominopelvic CT scan in blunt abdominal trauma.Open access emergency medicine : OAEM · 2019Article
- Diagnostic Accuracy of AST and ALT for Detecting Liver Injury in Blunt Abdominal Trauma.Journal of emergencies, trauma, and shockArticle
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5 authors at 3 institutions in 1 country.
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Abstract
backgroundComputed tomography (CT) is the gold standard in the initial evaluation of the hemodynamically stable patient with suspected liver trauma. However, the adverse effects of radiation exposure are of specific concern in the pediatric population. It is therefore desirable to explore alternative diagnostic modalities. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are hepatic enzymes, which are elevated in peripheral blood in relation to liver injury. The aim of the present study was to investigate a potential role of normal liver transaminase levels in the decision algorithm in suspected pediatric blunt liver trauma.
methodsRetrospective analysis of consecutively collected data from children (0-17 years) with blunt liver trauma, admitted to a single trauma centre in Denmark, between 2000 and 2013. Patients underwent abdominal CT during initial evaluation, and initial AST and/or ALT was measured. Based on local guidelines, we set the threshold for blood AST and ALT level to 50 IU/L. Nonparametric statistical tests were used.
resultsSixty consecutive children with liver injury following blunt abdominal trauma were enrolled in the study. All patients with normal AST and/or ALT level were treated conservatively with success. Information on both AST and ALT was available in 47 children. Of these 47 children, three children had AST and ALT levels ≤50 IU/L. These children suffered from grade I liver injuries, and were treated conservatively with no complications. DISCUSSION: All children who presented with blunt liver injury and AST and ALT levels ≤50 IU/L did not require treatment. These findings indicate that AST and ALT could be included in an updated management algorithm as a screening method to avoid abdominal CT. Notable limitations to the study was the retrospective method of data collection, without inclusion of a control group.
conclusionsCT seems superfluous in the initial evaluation of hemodynamically stable children with suspected blunt liver injury and blood AST and ALT levels ≤50 IU/L.
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