A comparison of diagnostic peritoneal lavage and computed tomography (CT scan) in evaluation of the hemodynamically stable patient with blunt abdominal trauma

Prospective Study of the Clinical Predictors of a Positive Abdominal Computed Tomography in Blunt Trauma Patients

“…Diagnostic peritoneal lavage (DPL) has been an accurate and well-tested method for many years and early studies advocate DPL over computed tomography (CT). [1][2][3][4][5] However, the wide availability, improved quality and decreased morbidity of abdominal CT has led to an increased acceptance and usage of CT in blunt trauma. 6 -10 Most now seem to agree that in the current system, CT and DPL are complementary not competitive modalities.…”

Evaluation of blunt abdominal trauma: current practice in Taiwan

“…The literature suggests that CT carries comparable sensitivity and superior specificity as compared with DPL and it is contraindicated in haemodynamically abnormal patients. 18 In our study, we found a minority of respondents (more surgeons than emergency physicians) decided to send haemodynamically abnormal patients to the radiology department for CT. They claimed that all patients are well monitored, the CT scanner is in the ED or immediately adjacent to the trauma resuscitation room, and rapid examination is anticipated with newer generation CT scanners.…”

Actual Diagnostic Strategies in Blunt Abdominal Trauma

“…Since nowadays more known injuries to spleen, liver, kidney, or pancreas are treated nonoperatively, CT makes an estimation of the degree of injury to these organs possible, resulting in fewer negative laparotomies or fewer surgery for insignificant injuries [2,3,41,51]. Certain studies indicate that there are several CT criteria that can be used to guide the need for operative management in liver and spleen injuries, especially any indications of injury to the vascular hilum or active bleeding [41].…”

“…The CT scan of the abdomen then has to be performed at regular intervals. The accuracy of this procedure in detecting splenic and hepatic injuries has been reported to be 95% in retrospective reviews and to be 99% accurate in detecting renal injuries [51,58].…”

“…The CT scan, however, has not been found as reliable in detecting hollow viscus injuries, pancreatic, mesenteric or bladder injuries in the period immediately after injury [12,48,49,51]. Multiple retrospective reviews have identified signs diagnostic or suspicious of hollow viscus injuries: bowel wall thickening, free fluid without solid organ injury, free peritoneal air, streaking of the mesentery, and extravasation of contrast [12,59].…”