Annals of surgery
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The evolution of nonoperative management of certain solid visceral injuries has stimulated speculation that management of the severely injured child is no longer a surgical exercise. The authors hypothesized that the incidence of injuries that require surgical evaluation is disproportionately high in children at risk of death or disability from significant injury. ⋯ These data clearly demonstrate the primacy of surgical pathology as the major determinant of outcome in pediatric injury. Operative intervention and the option of timely operative care remain major components of clinical management of children with injuries that pose a significant risk of morbidity or mortality.