Actual Diagnostic Strategies in Blunt Abdominal Trauma

An accurate assessment of patients with potential blunt abdominal trauma should include a safe and reliable method of determining the need for operative intervention because the mortality and morbidity of these injuries are directly dependent on the immediately valid diagnostic work-up. Since peritoneal signs are often subtle, overshadowed by pain from associated injury or masked by head trauma and intoxicants, clinical methods of diagnostics are often unreliable. Since the frequently injured liver and spleen are nowadays more frequently managed nonoperatively, an acute assessment not only of the presence of injury, but also of the nature and extent of the injuries to the intraabdominal organs, raises an increasing demand of both sensitive and specific diagnostic modalities. This article discusses the use of different diagnostic modalities including peritoneal lavage, computed tomography scanning, ultrasound and laparoscopy in the diagnosis and immediate management of blunt abdominal trauma patients, and formulates a trauma protocol for managing these patients. Received: June 21, 2001; revision accepted: February 15, 2002