Evaluation of the patient with blunt abdominal trauma: an evidence based approach.
Patients with blunt abdominal trauma present a special challenge to the emergency physician. Physical examination is often unreliable, even if the patient is awake, and the frequent co-existence of head injury exacerbates this problem. This article examines the evidence basis of three diagnostic modalities in evaluating blunt abdominal trauma: DPL (the time-honored test); CT scanning (the current standard of care); and abdominal sonography (the emerging standard--especially for examination conducted in the trauma room). A proposed algorithm for the appropriate use of these modalities is also presented.
Amoroso
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TA
Division of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
D000007:Abdominal Injuries / Q000175:diagnosis*; D000465:Algorithms; D019317:Evidence-Based Medicine; D006801:Humans; D010533:Peritoneal Lavage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*