A. Alves et al., Value of complementary investigations in the diagnosis and treatment of penetrating abdominal trauma., ANN CHIR, 52(9), 1998, pp. 927-934
There is persistent controversy concerning the management of patients with
abdominal trauma. The major point is to determine whether or not the abdomi
nal trauma is penetrating. In rare cases (shock, abdominal gunshot wound, p
eritonitis, evisceration, digestive tract bleeding and abdominal stab out o
f place) urgent laparotomy remains mandatory. In the other cases, although
some centers recommend serial abdominal exams for asymptomatic patients, wi
th the risk of delayed laparotomy, most authors prefer a more aggressive ap
proach. In the case of anterior penetrating abdominal trauma, diagnostic pe
ritoneal lavage, which is an over sensitive method, could be replaced by la
paroscopy, which allows both diagnosis and treatment. Triple-contrast CT sc
an is the first-line diagnostic modality in penetrating back and flank trau
ma.