Visceral injuries in children are mostly blunt and caused by traffic accidents, falling or tumbling. If the trauma mechanism and the child's symptoms suggest a visceral injury, referral to a hospital is always warranted. Bleeding from visceral organs is not uncommon in children. The most common visceral injuries comprise rupture of the spleen, the liver or a kidney. The most common pulmonary injuries are pneumothorax and pulmonary contusion. Injuries to the pancreas and to the bowel are clearly more uncommon. Injuries to the heart and to the large vessels are rare in children.