Faculty Collaboration Database

Evaluation of computed tomography and diagnostic peritoneal lavage in blunt abdominal trauma. J Trauma 1989 Aug;29(8):1168-70; discussion 1170-2

Date

08/01/1989

Pubmed ID

2760958

DOI

10.1097/00005373-198908000-00017

Scopus ID

2-s2.0-0024435878 (requires institutional sign-in at Scopus site)   147 Citations

Abstract

Three hundred one hemodynamically stable patients with equivocal abdominal examinations following blunt abdominal trauma had a CT scan followed by DPL. Both studies were negative in 194 patients (71.6%) and positive in 51 patients (27.1%). Seven of the 51 patients (13.7%) had an additional significant injury at operation that was not seen on the CT scan. Nineteen patients had a negative CT scan, a positive DPL, and a significant injury confirmed at celiotomy. In this group of 19 patients, the CT failed to identify seven splenic, three hepatic, and three small bowel injuries. There were two complications attributed to DPL. Three patients had a false negative DPL. Diagnostic peritoneal lavage continues to be a reliable study (sensitivity--95.9%, specificity--99%, accuracy--98.2%). The CT scan is not as sensitive (sensitivity--74.3%, p less than 0.001; specificity--99.5%, accuracy--92.6%). It is concluded that selective use of both procedures is appropriate as long as one recognizes the inherent limitations of each.

Author List

Meyer DM, Thal ER, Weigelt JA, Redman HC

MESH terms used to index this publication - Major topics in bold

Abdominal Injuries
Adolescent
Adult
Aged
Child
Child, Preschool
Evaluation Studies as Topic
Female
Humans
Infant
Male
Middle Aged
Peritoneal Lavage
Prospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating