Technology-driven triage of abdominal trauma: the emerging era of nonoperative management.
Selective nonoperative management of blunt or penetrating abdominal trauma is safe, has eliminated the complications associated with nontherapeutic laparotomies, and is cost-effective. Appropriately selected investigations, such as focused abdominal sonography for trauma, diagnostic peritoneal lavage, spiral computed tomography (CT) scan, diagnostic laparoscopy, or thoracoscopy and angiography, play a critical role in the triage of patients. Future technological advances, such as improvement of the ultrasonic hardware and software that provide automated interpretation and the availability of portable CT scan machines in the emergency room, may improve the speed and accuracy of the initial evaluation. Improvement of the optical system of minilaparoscopes may allow reliable bedside laparoscopy for suspected diaphragmatic injuries.
Demetriades
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Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. demetria@usc.edu velmahos@usc.edu
Velmahos
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D000007:Abdominal Injuries / Q000145:classification / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics; D006801:Humans; D010535:Laparoscopy / Q000191:economics; D010533:Peritoneal Lavage / Q000191:economics; D011379:Prognosis; D014218:Triage / Q000191:economics; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D014950:Wounds, Penetrating / Q000145:classification / Q000175:diagnosis* / Q000191:economics / Q000628:therapy