SECONDARY PERITONITIS FOLLOWING NEGATIVE CT SCAN FOR BLUNT ABDOMINAL-TRAUMA

Diagnostic peritoneal lavage has widely been replaced by emergency son ography in the evaluation of blunt abdominal trauma. CT is generally p erformed in cases without major hemodynamic instability in order to de fine non-operative treatment of injuries of the parenchymatous organs or to precise the extension of retroperitoneal, spinal and pelvic lesi ons. Despite the good results of this method for the mentioned indicat ions, the low sensitivity of CT for lesions of hollow viscus should no t be forgotten. We report 3 cases of lesions of the small bowel (2 per forations and 1 mesenteric lesion with ischemic bowel wall) which were not visible, even retrospectively, at the CT. Despite discrete clinic al signs, these lesions were only diagnosed at the stage of obvious se condary peritonitis. These cases should remind us the limits of CT in the evaluation of abdominal visceral lesions in blunt trauma.