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BACKGROUND: Assessment of patients in the emergency department who sustain blunt abdominal trauma represents a significant diagnostic challenge. Computed tomography (CT) is increasingly used as the principal investigation for these patients. A sensitive screening test could safely reduce the use of CT. OBJECTIVES: To appraise the evidence supporting the use of diagnostic peritoneal lavage and focused abdominal sonography for trauma as screening tests in the emergency department to reduce the use of CT in the initial assessment of patients sustaining blunt abdominal trauma. METHODS: A search of high-quality evidence resources was performed, followed by a hand search of the bibliographies of all relevant articles. RESULTS: Altogether, 55 articles were found during the initial search, of which 23 were relevant. An additional 11 were found by hand searching. Six relevant original research articles were found. CONCLUSION: Screening diagnostic peritoneal lavage and selective CT is a safe diagnostic strategy for the investigation of blunt abdominal trauma. Further research is needed to determine the role of focused abdominal sonography for trauma scanning in diagnostic protocols.

Original publication

DOI

10.1097/01.ta.0000250493.58701.ad

Type

Journal article

Journal

The Journal of trauma

Publication Date

03/2007

Volume

62

Pages

779 - 784

Addresses

Emergency Department, John Radcliffe Hospital, Oxford. x.griffin@tiscali.co.uk

Keywords

Abdomen, Humans, Abdominal Injuries, Wounds, Nonpenetrating, Tomography, X-Ray Computed, Radiography, Abdominal, Peritoneal Lavage