Beyond the Pan-Scan: Optimizing Imaging and Management in Pediatric Blunt Trauma - a Narrative Review

Aboali A. A., Elewa M., Akinbi O. M., Alhaddad J., Hadhoud A. M., Pyala R., ...Daha Fazla

CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS, cilt.14, sa.1, 2026 (ESCI)

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Purpose of Review Pediatric blunt trauma is a significant public health concern and a leading cause of childhood morbidity and mortality worldwide. Rapid and accurate evaluation of internal injuries is essential in these cases. The pan-scan, or whole-body computed tomography (CT) of the head, cervical spine, chest, abdomen, and pelvis, is widely used in adult trauma for comprehensive assessment, but its role in pediatric trauma remains controversial. This narrative review examines the balance between diagnostic yield and radiation risk in pediatric blunt trauma imaging. Recent Findings Ionizing radiation poses a greater long-term risk in children due to tissue radiosensitivity and increased lifetime malignancy risk. Although whole-body CT may detect additional occult injuries in selected high-risk pediatric patients, available studies suggest that management is altered in only a small proportion of cases (generally < 5-10%), with no consistent mortality benefit demonstrated. Many children undergoing pan-scan ultimately do not require therapeutic intervention. Summary A selective imaging strategy based on careful clinical assessment, injury mechanism, and adjuncts such as focused assessment with sonography for trauma (FAST) can optimize diagnostic accuracy while minimizing unnecessary radiation exposure. This approach aligns with the ALARA principle and supports judicious use of CT imaging in pediatric blunt trauma.