Incidence and significance of free fluid on abdominal computed tomographic scan in blunt trauma. J Trauma 1998 May;44(5):889-92
Date
05/29/1998Pubmed ID
9603094DOI
10.1097/00005373-199805000-00024Scopus ID
2-s2.0-0031802662 (requires institutional sign-in at Scopus site) 104 CitationsAbstract
OBJECTIVE: To determine the incidence and significance of free fluid on abdominal CT in blunt trauma.
DESIGN: Retrospective chart review.
METHODS: All blunt trauma patients with an abdominal computed tomographic scan from August of 1993 to December of 1995 were identified from the trauma registry at a Level 1 trauma center. A total of 1,159 computed tomographic scans were performed; records of 18 patients were excluded for incomplete records. Official reports of computed tomographic scans were reviewed for free fluid, solid organ injury, bladder injury, and pelvic fracture.
RESULTS: Free fluid without solid organ injury was found in 3% (34 of 1141). Laparotomy was performed because of free fluid in 13 patients. There were six small bowel injuries and one diaphragm injury for a therapeutic laparotomy rate of 54%. Ten patients had trace free fluid and did not undergo laparotomy; none had a missed small bowel injury.
CONCLUSIONS: The presence of more than trace amounts of free fluid without solid organ injury in patients with blunt trauma is a strong indication for exploratory laparotomy. Patients with isolated trace amounts of free fluid can be safely observed.
Author List
Brasel KJ, Olson CJ, Stafford RE, Johnson TJMESH terms used to index this publication - Major topics in bold
Abdominal InjuriesAdolescent
Adult
Aged
Aged, 80 and over
Ascitic Fluid
Child
Child, Preschool
Female
Humans
Incidence
Infant
Infant, Newborn
Intestine, Small
Male
Middle Aged
Radiography, Abdominal
Tomography, X-Ray Computed
Wounds, Nonpenetrating
