RESUMEN
Abdominal trauma may result in a variety of intra-abdominal injuries, ranging in severity from mild to life threatening. Nowadays, the choice of investigation and management depends primarily on the haemodynamic stability of the patient Ultrasound [U/S], diagnostic protineal lavage [DPL] and Laparoscopy are widely used in the diagnosis of blunt abdominal trauma [BAT]. Historically, exploratory laparotomy was done for the patient clinically suspected to have intra-abdominal organ injury following blunt abdominal trauma. If following initial survey and assessment abdominal signs continue to be equivocal laparoscopy provides the most definitive early evaluation technique. In this study, 60 patients with history of blunt abdominal trauma were included. Diagnostic laparoscopy failed to detect splenic injuries in 2 patents out of the 60 patients studied because of a large clot in the left upper quadrant, 48 patients were exposed to laparotomy. The most common findings in those 48 patients were isolated liver injuries in 20 patients [33.3%] followed by isolated splenic injuries in 6 patients [10%]. DPL and US can be performed for patients with BAT while they are being resuscitated. Conservative treatment in properly selected patients has become the standard. Among 15 patients who were chosen to be treated conservotivelly, twelve patients underwent conservative treatment in this study with a success rate of 80% and three patient needed an exploratory laparotomy due to haemodynamic instability that developed during the follow-up period. Abdominal ultrasonography has proved to be of little value in deciding the possibility of conservative treatment due to inability to detect the grade of solid organ injury. DPL has no role in conservative treatment of blunt abdominal injuries. Early identification of significant infra-abdominal injuries is necessary for the successful management of blunt abdominal trauma because delay in diagnosis can lead to significant morbidity and mortality The rapidly increasing role of diagnostic and therapeutic laparoscopy in current surgical practice prompted us to investigate the potential role this procedure in the assessment and management of stable patients with U/S evidence of solid organ injury [SOIs] after blunt abdominal trama. Laparoscopy decreases the rate of unnecessary laparotomies in abdominal trauma and helps to diagnose injuries of solid organs. Frequent clinical evaluation of the patients' condition, ultrasonograpy and DPL are complementary and important in the diagnosis and management of the patients with abdominal trauma