title: The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries: 10-year experience at a level 1 trauma center.
abstract: BACKGROUND
  Diagnostic laparoscopy (DL) has decreased the rate of nontherapeutic laparotomy for patients suffering from penetrating injuries. We evaluated whether DL similarly lowers the rate of nontherapeutic laparotomy for patients with blunt injuries.
  
  
  METHODS
  All patients undergoing DL over a 10-year period (ie, 2001-2010) in a single level 1 trauma center were classified by the mechanism of injury. Demographic and perioperative data were compared using the Student t and Fisher exact tests.
  
  
  RESULTS
  There were 131 patients included, 22 of whom sustained blunt injuries. Patients suffering from blunt injuries were more severely injured (Injury Severity Score 18.0 vs 7.3, P = .0001). The most common indication for DL after blunt injury was a computed tomographic scan concerning for bowel injury (59.1%). The rate of nontherapeutic laparotomy for patients sustaining penetrating vs blunt injury was 1.8% and nil, respectively.
  
  
  CONCLUSIONS
  DL, when coupled with computed tomographic findings, is an effective tool for the initial management of patients with blunt injuries.
authors: Department of Surgery, University of Oklahoma College of Medicine, 920 Stanton L. Young Blvd, WP 2140, Oklahoma City, OK 73104, USA. Jeremy-j-johnson@ouhsc.edu
authors: Jeremy J
authors: JJ
authors: Johnson
authors: Tabitha
authors: T
authors: Garwe
authors: Alexander R
authors: AR
authors: Raines
authors: Joseph B
authors: JB
authors: Thurman
authors: Sandra
authors: S
authors: Carter
authors: Jeffrey S
authors: JS
authors: Bender
authors: Roxie M
authors: RM
authors: Albrecht
mesh_terms: D000007:Abdominal Injuries / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D009825:Oklahoma; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery