Patients who have had blunt abdominal trauma may be managed using an algorithmic approach.
The initial step is to assess vital signs.
Unstable Vital Signs
If vital signs are unstable, then perform ultrasonography.
(1) If intraperitoneal fluid is present, then perform an emergency laparotomy.
(2) If intraperitoneal fluid is absent, then search for other bleeding sites.
Stable Vital Signs
If vital signs are stable, then diagnostic peritoneal lavage is performed.
(1) If the lavage gives negative results by the classic criteria, then intraperitoneal injury is unlikely.
If the lavage is positive, then a cell count ratio is performed.
(1) If the cell count ratio is positive (>=1), then laparotomy is performed.
(2) If the cell count ratio is negative (< 1), then a CT scan is performed.
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Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Gastroenterology
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