The Pediatric Surgery Research Collaborative (PedSRC) Rule is a clinical prediction rule for children with blunt abdominal trauma. It is designed to identify patients who are at very low risk of intra-abdominal injury (IAI) and especially those at very low risk of IAI requiring acute intervention, so some children may be able to avoid an abdominal CT scan.

The original PedSRC rule is a 5-variable rule based on findings available in the trauma bay:
AST >200 U/L, abnormal abdominal exam, abnormal chest x-ray, abdominal pain, and abnormal pancreatic enzymes.

In plain language, it helps answer:
“Is this child’s risk low enough that a CT scan may not be necessary?”
That matters because CT can detect injuries, but it also exposes children to radiation. The PedSRC rule was developed and then externally validated to support safer CT decision-making after blunt abdominal trauma.

In the external validation study, children with none of the 5 abnormal variables had a 99.3% negative predictive value for any IAI and 100% negative predictive value for IAI requiring acute intervention, which is why the rule is described as identifying a very-low-risk group.

One useful detail: PedSRC is not the same as the PECARN blunt abdominal trauma rule. Recent validation work suggests PECARN is strong for injuries requiring intervention, but adding trauma-bay labs and chest x-ray, as in PedSRC-style approaches, may better identify children at very low risk for all intra-abdominal injuries.