Abdominal Trauma

Explanation

This hemodynamically stable child has a significant mechanism of injury (handlebar impact) and abdominal findings. While the FAST exam is negative for free fluid, it has low sensitivity for solid organ or hollow viscus injury. According to current guidelines, the gold standard for diagnosing intra-abdominal injury in a stable pediatric patient is a contrast-enhanced CT scan. It provides detailed information on the grade of organ injury (e.g., liver, spleen, pancreas) and can detect hollow viscus injuries or hematomas that would be missed by FAST. Admission (A) may follow the CT results, but imaging is needed first to guide management. Immediate laparotomy (B) is reserved for hemodynamically unstable patients. Discharge (D) is unsafe without further evaluation given his symptoms.