Blunt trauma in intoxicated patients: is computed tomography of the abdomen always necessary?
BACKGROUND
Physical examination to detect abdominal injuries has been considered unreliable in alcohol-intoxicated trauma patients. Computed tomography (CT) plays the primary role in these abdominal evaluations.


METHODS
We reviewed medical records of all blunt trauma patients admitted to our trauma service from January 1, 1992, to March 31, 1998. Study patients had a blood alcohol level > or =80 mg/dL, Glasgow Coma Scale (GCS) score of 15, and unremarkable abdominal examination.


RESULTS
Of 324 patients studied, 317 (98%) had CT scans negative for abdominal injury. Abdominal injuries were identified in 7 patients (2%), with only 2 (0.6%) requiring abdominal exploration. A significant association was found between major chest injury and abdominal injury.


CONCLUSIONS
The incidence of abdominal injury in intoxicated, hemodynamically stable, blunt trauma patients with a normal abdominal examination and normal mentation is low. Physical examination and attention to clinical risk factors allow accurate abdominal evaluation without CT.
Mavridis
S P
SP
Department of Surgery, Conemaugh Memorial Medical Center, Johnstown, Penn, USA.
Firilas
A M
AM
D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011859:Radiography; D012307:Risk Factors; D014193:Trauma Centers