URGENT LAPAROTOMY VERSUS EMERGENCY CRANIOTOMY FOR MULTIPLE TRAUMA WITH HEAD-INJURY PATIENTS

In blunt multiple trauma (MT) with head injury (HI) patients, it is di fficult to decide whether to proceed with immediate laparotomy or cran iotomy, In August 1989, abdominal ultrasonography (US) using a simple US scoring system was introduced for MT and HI patients as an initial rapid screening procedure, In MT and HI patients with a US score great er than or equal to 3 (n = 14), urgent laparotomy was the procedure of first choice. However, immediate head CT scan, then emergency craniot omy, may be justified in hemodynamically stable MT and HI patients wit h a US score < 3 (n = 98). Appropriate decision making can be applied to decide which procedure is most exigent.