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.
KeywordsObesity Catheter Dioxide Europe Syringe
Unable to display preview. Download preview PDF.
- 1.Read RA, Moore EE (1993) Abdominal trauma. In Levine BA, Copeland EM, Howard RJ, Sugerman HJ, Warshaw AL (eds) Current practice of surgery, vol 1. Churchill Livingstone, New York, pp 1–21Google Scholar
- 2.Colucciello S (1965) Blunt abdominal trauma. Emerg Med Clin North Am 11:107–123Google Scholar
- 10.Committee on Trauma, American College of Surgeons (1993) Advanced trauma life support student manual: ATLS course for physicians, 5th edn. American College of Surgeons, ChicagoGoogle Scholar
- 13.Wisner DH, Danto LA (1994) Peritoneal lavage, computerized tomography, angiography, ultrasound, and magnetic resonance imaging. In: Blaisdell FW, Trunkey DD (eds) Abdominal trauma, 2nd edn. Trauma management I, II. Thieme Medical, New York, pp 32–56Google Scholar
- 15.Wing VW, Federle MP, Morris JA Jr, Jeffrey RB, Bluth R (1985) The clinical inpact of CT for blunt abdominal trauma. Am J Radiol 145:1191–1194Google Scholar
- 19.Dietrich J, Avavino J, Karamenoukian H (1993) Emergency department ultrasound in the evaluation of blunt abdominal trauma. Emerg Med 11:342–346Google Scholar
- 27.Brandt CP, Priebe PP, Jacobs DG (1954) Potential of laparoscopy to reduce non-therapeutic trauma laparotomies. Am Surg 60:416–420Google Scholar