The Role of Computed Tomography and Diagnostic Peritoneal Lavage in Blunt Abdominal Trauma

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Journal of the Korean Society of Traumatology 1990;3(2):83-172.

Myung Soo Kim, Joon Pil Cho, Hoon Sang Chi

복부둔상세에서 진단적 복강세척술과 복부 전산화단층촬영의 진단적 의의

김명수, 조준필, 지훈상

Abstract

We reviewed retrospectively medical records and films of 83 patients who underwent abdominal computed tomogram and/or diagnostic peritoneal lavage following abdominal blunt trauma between January 1986 and december 1990. Thirty eight among 83 patients were operated because of positive findings of abdominal computed tomogram and/or diagnostic peritoneal lavage. Only one patient of thirty eight revealed no definite intraaabdominal organ injuries except non significant retroperitoneal hematoma due to pelvic bone fracture. The interval time from initial evaluation at emergency room to laparotomy was average 8.4 hours. Positive findings of diagnostic peritoneal lavage provided fastest discision of laparotomy, of which time interval was average 6.4 hours. Diagnostic peritoneal lavage showed that sensitivity was 95.8%, specificity 85.7%, and accuracy 93.5%. Abdominal computed tomogram showed that sensitivity was 75.0%, specificity 100%, and accuracy 73.9%. False negative findings were more frequent in patients who was taken abdominal computed tomogram than diagnostic peritoneal lavage. We conclude that in order to facilitate the early and precise recognition of intraab-dominal organ injuries following blunt abdominal trauma, diagnostic peritoneal lav-age is more superior method to abdominal computed tomogram. Nevertheles abdo-minal computed tomogram is non invasive procedures and provides intraabdominal or retroperitoneal organ specific findings. So abdominal computed tomogram helps us to manage hemodynamically stable patients conservatively dependent upon degree of solid organ injuries or retroperitoneal hematoma under close observation.

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