consider those self-limiting or nonspecific causes of abdominal pain The algorithm presented in this chapter for the approach to abdominal pain is shown in Figure 53.1 Abdominal Pain in the Setting of Trauma In the setting of major trauma, the physician should perform a rapid physical examination to distinguish superficial injury (e.g., soft tissue or muscle contusion) from significant intra-abdominal trauma (e.g., splenic hematoma or rupture, liver injury, or hollow viscus perforation) (see Chapter 103 Abdominal Trauma ) Children with localized and/or acute pain after blunt trauma may appear surprisingly well yet have significant solid organ or hollow viscus trauma When significant intra-abdominal injury is suspected in a stable patient, an urgent computed tomography (CT) scan should be obtained to evaluate for solid organ injury Lacerations of the liver and spleen are the most common intra-abdominal injuries seen in children Bedside ultrasound (f ocused a ssessment with s onography in t rauma [FAST]) may be used to evaluate for hemoperitoneum The sensitivity of ultrasound for the detection of solid organ injury is low, and some children with liver and splenic lacerations have minimal intra-abdominal fluid Given the low sensitivity of the FAST exam for detecting solid organ injury and hemoperitoneum, it should not be used as the sole diagnostic test to exclude intraabdominal injury in children