Blunt injury abdomen, hemodynamically stable, investigation of choice:
|A||Diagnostic Peritoneal Lavage|
a. USG is the investigation of choice in hemodynamically unstable patient. Computer tomography is the investigation of choice in hemodynamically stable patient.
b. Since concealed hemorrhage is the second most common cause of death after trauma and missed abdominal injuries are a frequent cause of morbidity and late mortality who survive the early period after injury.
c. FAST (Focused abdominal sonogram for trauma) is the technique using ultrasound to assess the abdomen. This involves a limited number of ultrasound windows to detect fluid: right upper quadrant (Morrison’s pouch), left upper quadrant (Splenorenal recess and subdiaphragmatic space); the pouch of Douglas and pericardial window to asses for pericardial effusion.
d. In the stable patient with blut abdominal injury, CT is the investigation of choice. A standard trauma scan with a modern spiral scanner can be acquired in 3-5 min. and should include intravenous contrast, the use of oral contrast is unnecessary in trauma patients.
e. The advantages of CT are the capacity to visualize retroperitoneum in addition to peritoneal structure.