Introduction
The abdomen is also known as the belly. It holds organs, including the:
- spleen - found on the left side of the belly, under the ribcage
- kidneys - found towards the back, one on either side of the spine, below the ribcage
- liver - found on the right side of the belly, under the ribcage, above the stomach, right kidney and intestines.
Abdominal organ injury is when these organs are damaged or hurt because of physical trauma like:
- car accidents
- assault or hitting
- crashing a bicycle or skateboard
- falling from a height
- playing contact sports.
A hard hit to the belly can cause a bruise or a cut in the organ, which can cause it to bleed out into the body. With kidney injury, there is also the risk of urine leaking and collecting around the kidney.
Signs and symptoms
Abdominal organ injury usually happens after physical trauma, like hitting or falling.
Signs and symptoms of an injury include:
- pain in the belly and/or back
- pain across the shoulders
- looking pale
- feeling sleepy
- feeling dizzy
- nausea or vomiting
- urine that is pink or red from blood.
Take your child to the nearest emergency department if they show symptoms after an accident, hit or fall.
Diagnosis
It can be difficult to see whether there is an injury to an abdominal organ, especially if there is no bruising and your child’s blood pressure shows normal.
An ultrasound can be done in the emergency department to see if there is fluid in your child’s belly. Fluid in the belly is usually blood or urine from an injured organ. This ultrasound is called a “focused assessment with sonography for trauma”, or FAST scan.
If the doctor thinks your child has an abdominal organ injury, your child will have a CT scan to check how severe the injury is. Injuries are graded from 1 - a mild injury to 5 - a severe injury.
Treatment
Your child may be admitted to the hospital after being diagnosed with an abdominal organ injury. The type of treatment and length of stay will depend on how severe the injury is. Most children with abdominal organ injury are treated with:
- fluids
- rest
- pain medication
- special diet
- breathing exercises.
Sometimes, they may also need a urine catheter to help empty the bladder.
Your child will have regular blood pressure checks and blood tests to see how their injured organ is functioning and whether it is still bleeding.
Some children with serious abdominal organ injuries may need surgery, but this is rare for injuries to the:
- spleen
- liver
- kidneys.
Your child’s doctor will talk to you before any treatment or surgery.
Your child can be discharged from hospital when they:
- can manage their pain and discomfort well enough
- are eating and drinking
- can do a poo.
The doctors will decide when your child can go home.
Management
Caring for your child at home
Your child’s treatment team will give you discharge instructions with advice on pain relief and safe activity levels.
Do not give your child any other medications without talking to your doctor first.
Activities should be gentle and help your child to rest and recover. They might include things like:
- board games
- slow walks
- craft
- screen time - movies, TV and video games.
Your child should not do anything that could lead to another hit to the belly, including:
- wrestling
- rough play
- climbing
- jumping on the bed
- sports.
Return to the Emergency Department or call an Ambulance on triple zero (000) if your child experiences:
- fever
- pain that gets worse
- dizziness
- vomiting
- worsening shoulder pain
- jaundice - yellowing of skin and eyes
- blood in the urine, poo or vomit
- further injury to the abdomen.
Contact your local doctor immediately if you have any concerns.
Returning to regular activities
Your child should rest at home until they are feeling back to normal. They can usually return to school 1-2 weeks after the injury, but checking with their doctor first is important.
Your child should not return to activities that may cause another hit to the belly until the doctor says it is okay. Activities to avoid can include:
- bike riding
- skateboarding
- trampolines
- sports
- other high-impact activities.
With more severe injuries, it may be 1-2 months or longer before your child can do these activities again. This is because the risk of getting knocked in the tummy again while still healing is high.
Your child’s treatment team will give you specific discharge instructions about returning to sports. Always ask the doctor or nurse if you have a question or concern.
When to see your doctor
Your child may need to see the doctor for a follow-up appointment 4-6 weeks after going home from the hospital. This appointment will include a progress check or scan.
Children who have injured their kidneys may also need their blood pressure checked by their local doctor for some time after going home to ensure the kidneys are working properly.