Are diagnostic peritoneal lavage or focused abdominal sonography for trauma safe screening investigations for hemodynamically stable patients after blunt abdominal trauma? A review of the literature.
BACKGROUND
Assessment of patients in the emergency department who sustain blunt abdominal trauma represents a significant diagnostic challenge. Computed tomography (CT) is increasingly used as the principal investigation for these patients. A sensitive screening test could safely reduce the use of CT.


OBJECTIVE
To appraise the evidence supporting the use of diagnostic peritoneal lavage and focused abdominal sonography for trauma as screening tests in the emergency department to reduce the use of CT in the initial assessment of patients sustaining blunt abdominal trauma.


METHODS
A search of high-quality evidence resources was performed, followed by a hand search of the bibliographies of all relevant articles.


RESULTS
Altogether, 55 articles were found during the initial search, of which 23 were relevant. An additional 11 were found by hand searching. Six relevant original research articles were found.


CONCLUSIONS
Screening diagnostic peritoneal lavage and selective CT is a safe diagnostic strategy for the investigation of blunt abdominal trauma. Further research is needed to determine the role of focused abdominal sonography for trauma scanning in diagnostic protocols.
Griffin
Xavier L
XL
Emergency Department, John Radcliffe Hospital, Oxford. x.griffin@tiscali.co.uk
Pullinger
Rick
R
D000005:Abdomen / Q000000981:diagnostic imaging*; D000007:Abdominal Injuries / Q000175:diagnosis*; D006801:Humans; D010533:Peritoneal Lavage; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*