title: Missed diagnosis and delayed laparotomy in blunt abdominal trauma.
abstract: Abdominal organ injuries caused by blunt trauma are notoriously difficult to diagnose and a vital operation may as a result be dangerously delayed. In a series of 331 patients admitted after blunt abdominal trauma, 426 abdominal organ injuries were registered. 152 of these patients had 199 abdominal organ injuries requiring surgical repair. In 31 of these patients (20%) with 44 organ injuries operation was delayed for more than 6 hours after admission, in most instances because the diagnosis had been missed. One of these patients died as a consequence. Hollow organ injuries were the most commonly missed. Peritoneal lavage, repeated if necessary, and diagnostic imaging must be used as valuable tools in addition to repeated clinical evaluation, especially in comatose patients, in patients with multiple injuries, and in intoxicated patients.
authors.affiliation: Department of Surgery, Ullevål University Hospital, Oslo, Norway.
authors.forename: F
authors.initials: F
authors.lastname: Naess
authors.forename: A
authors.initials: A
authors.lastname: Nesbakken
authors.forename: K
authors.initials: K
authors.lastname: Solheim
authors.forename: J
authors.initials: J
authors.lastname: Pillgram-Larsen
authors.forename: T
authors.initials: T
authors.lastname: Gerner
authors.forename: J O
authors.initials: JO
authors.lastname: Stadaas