Technology-Driven Triage of Abdominal Trauma: The Emerging Era of Nonoperative Management

Selective nonoperative management of blunt or penetrating abdominal trauma is safe, has eliminated the complications associated with nontherapeutic laparotomies, and is cost-effective. Appropriately selected investigations, such as focused abdominal sonography for trauma, diagnostic peritoneal lavag...

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Bibliographic Details
Published in:Annual review of medicine 2003-01, Vol.54 (1), p.1-15
Main Authors: Demetriades, D, Velmahos, G
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Injuries - classification
Abdominal Injuries - diagnosis
Abdominal Injuries - economics
Abdominal Injuries - therapy
blunt
Cost control
Cost-Benefit Analysis
diagnosis
Diagnostic Imaging - economics
Emergency medical care
Hemodynamics
Humans
Laparoscopy
Laparoscopy - economics
Laparotomy
Medical imaging
Morbidity
Mortality
penetrating
Peritoneal Lavage - economics
Prognosis
Tomography
Trauma
Triage - economics
Ultrasonic imaging
Wounds, Nonpenetrating - classification
Wounds, Nonpenetrating - diagnosis
Wounds, Nonpenetrating - economics
Wounds, Nonpenetrating - therapy
Wounds, Penetrating - classification
Wounds, Penetrating - diagnosis
Wounds, Penetrating - economics
Wounds, Penetrating - therapy
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Summary:Selective nonoperative management of blunt or penetrating abdominal trauma is safe, has eliminated the complications associated with nontherapeutic laparotomies, and is cost-effective. Appropriately selected investigations, such as focused abdominal sonography for trauma, diagnostic peritoneal lavage, spiral computed tomography (CT) scan, diagnostic laparoscopy, or thoracoscopy and angiography, play a critical role in the triage of patients. Future technological advances, such as improvement of the ultrasonic hardware and software that provide automated interpretation and the availability of portable CT scan machines in the emergency room, may improve the speed and accuracy of the initial evaluation. Improvement of the optical system of minilaparoscopes may allow reliable bedside laparoscopy for suspected diaphragmatic injuries.
ISSN:0066-4219
1545-326X
DOI:10.1146/annurev.med.54.101601.152512