Initial management of children is identical to that of adults. In children, however, certain predisposing factors may alter the diagnostic evaluation. The diagnostic process itself may be associated with significant morbidity. Young children must often be anesthetized to undergo diagnostic procedures. Angiography is technically more difficult due to the smaller vessel size. Hall et al. have suggested observation alone in asymptomatic children with zone II penetrating injuries. 14 The authors caution that this practice should only be followed if close, active observation by skilled consultants can be performed and operative facilities are immediately available.
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