Blunt abdominal trauma

Motor vehicle collisions and falls are the most common causes of blunt trauma.

CT scan of the abdomen is the diagnostic modality of choice in the emergency department.

Selective nonoperative management is the standard of care for blunt injuries and stab wounds.

Helical CT scanners has rendered exploratory operations obsolete for diagnostic purposes except when the patient is hemodynamically unstable, particularly with ongoing bleeding.

For the majority of patients with blunt trauma once the airway is stabilized and fluid resuscitation is achieved diagnostic radiology is the next step.

Abdominal exploration should take place in a warmed operating room with adequate personnel, adequate blood resources and staffing with initial control of bleeding or fecal contamination, and then a systematic evaluation of abdominal and retroperitoneal contents to find all injuries.

Diagnostic abdominal exploration includes examination of the entire gastrointestinal tract from the esophagus to rectum, the liver, spleen, entire retroperitoneum including the kidneys, pancreas, duodenum and major vascular structures.

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