Non penetrating abdominal trauma: Key points to explore or to conserve

ABSTRACT

Seventy-eight patients with blunt abdominal trauma [either isolated or as a part of polytrauma] were stratified into four management groups based on a clinical scoring system. Immediate laparotomy was done in 36 cases, diagnostic peritoneal lavage followed by further management in 18 cases, auxiliary radiological investigation in the form of ultrasonography and/or CT scan in 14 cases and the conservative treatment based on mere clinical judgment in 10 cases. The study devised a Clinical Abdominal Scoring System [CASS] which helped in proper patient selection for definitive management. This is reflected on the high accuracy and specificity of the auxiliary radiological investigation [100%] and minimizes cost as well as subsequent mortality that would result from delayed or improper diagnosis