Emergency patients frequently are required to evaluate patients who have sustained blunt abdominal trauma from a variety of mechanisms. The management of these patients is an ongoing challenge to the emergency physician (EP). Blunt abdominal trauma usually occurs in the setting of multisystem injury following a motor vehicle collision (MVC), fall, or other high-speed energy transfer. The high incidence of concomitant CNS injury makes traditional methods of diagnosis (e.g., history, physical examination) unreliable. Proper diagnosis and management usually require the application of a number of complementary diagnostic modalities.

It has been estimated that about 6% of all patients presenting with blunt abdominal trauma from any mechanism will have injuries requiring laparotomy; this reflects to some extent a changing pattern of “need for laparotomy” because more injuries, especially to the frequently injured liver and spleen,<sup>1Bode P.J., Niezen A., van Vugt A.B., et al. Abdominal ultrasound as a reliable indicator for conclusive laparotomy in blunt abdominal trauma J Trauma 1993 ;  34 : 27 [cross-ref]

Cliquez ici pour aller à la section Références</sup> can be managed nonoperatively. Both operative and nonoperative management require an acute assessment of not only the presence of injury to the organs affected but also the nature and extent of the injuries. As a result, the demands on a diagnostic modality to be not only sensitive, but specific, are increasing.

This article examines the evidence underlying the use of CT scanning, diagnostic peritoneal lavage (DPL), and ultrasonography (US) for the diagnosis and immediate management of the patient with blunt abdominal trauma. It is also the purpose of this article to formulate an evidenced-based protocol for managing the patient with blunt abdominal trauma in the initial stages of the trauma resuscitation.