Procedures in Blunt Abdominal Trauma

Modern traumatology uses scoring systems to determine the efficiency of treat­ment. Surgeons employ a variety of diagnostic modalities for the assessment of blunt abdomi­nal trauma, the choice of the modality depending on the severity of general status of the critically injured patient. Ninety-nine severely injured patients, included in the 3-year Slovenian Society of Trauma Sur­geons Protocol of Severely Traumatised, were laparotomised because of blunt abdominal trau­ma. A retrograde analysis was used to determine the impact of the severity of trauma, as defined by the Revised Trauma Score (RTS) and the Injury Severity Score (ISS), on the diagnostic modality used to assess blunt abdominal trau­ma prior to undertaking laparotomy. The average ISS value was statistically significantly lower in patients with a positive ultrasonic diagnosis than in patients with a positive diagnostic peri­toneal lavage (p< 0.003). The average RTS value was significantly higher in patients with a positive ultrasound than in patients with posi­tive results of diagnostic peritoneal lavage (p < 0.02). To save them time, surgeons evalua­ted gravely affected patients with severe abdominal trauma who had low RTS and high ISS scores by diagnostic peritoneal lavage which was performable simultaneously with the resuscitation procedure. Patients with clinically suspected blunt abdominal trauma, showing higher RTS and lower ISS scores were evalua­ted by ultrasound.