Diagnostic Procedures in Abdominal and Retroperitoneal Injury
In the United States trauma is the fourth leading cause of death and the most frequent cause of mortality in persons under the age of 45 years . The distribution of abdominal trauma is almost evenly divided between penetrating and blunt. With penetrating trauma the ability to assess the injury is relatively easy, whereas in blunt trauma the injury is often more subtle, particularly when there are major associated injuries such as rib fractures, extremity fractures, or an altered sensorium due to intoxicants or head injury. In all instances a high index of suspicion must be present on the part of the clinician, because the rule is “blood somewhere, blood nowhere, blood must be in the abdomen.” The extremities, neck, and chest can be readily examined, but the abdomen represents the “black box” where either retroperitoneal injury, intraperitoneal injury, or both can exist without obvious external manifestations. Prior to the advent of current diagnostic modalities up to 17% of patients with abdominal trauma died secondary to unrecognized intra-abdominal bleeding [2, 3]. The purpose of this chapter is to discuss the diagnostic procedures available for the evaluation of intraperitoneal and retroperitoneal injury.
KeywordsBlunt Trauma Abdominal Trauma Peritoneal Lavage Abdominal Injury Blunt Abdominal Trauma
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