Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy

David H. Livingston, Robert F. Lavery, Marian R. Passannante, Joan H. Skurnick, Stephen Baker, Timothy Fabian, Donald E. Fry, Mark A. Malangoni

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal CT after blunt abdominal trauma. Methods: This study was a multicenter prospective series of all patients with blunt abdominal trauma admitted to four level I trauma centers over 22 months. Data were collected concurrently at the time of patient enrollment and included demographics, injury severity score, findings on CT scan, and presence or absence of blunt intestinal injury. This database was specifically queried for those patients who had free fluid without solid organ injury. Results: In all, 2,299 patients were evaluated. Free fluid was present in 265. Of these, 90 patients had isolated free fluid with only 7 having a blunt intestinal injury. Conversely, 91% of patients with free fluid did not. All patients with free fluid were observed for a mean of 8 days (95% confidence interval 6.1 to 10.4, range 1 to 131). There were no missed injuries. Conclusions: Free fluid on abdominal CT scan does not mandate celiotomy. Serial observation with the possible use of other adjunctive tests is recommended.

Original languageEnglish (US)
Pages (from-to)6-9
Number of pages4
JournalAmerican Journal of Surgery
Volume182
Issue number1
DOIs
StatePublished - Sep 6 2001

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Abdominal Injuries
Nonpenetrating Wounds
Tomography
Wounds and Injuries
Injury Severity Score
Trauma Centers
Delayed Diagnosis
Observation
Demography
Databases
Confidence Intervals
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Livingston, D. H., Lavery, R. F., Passannante, M. R., Skurnick, J. H., Baker, S., Fabian, T., ... Malangoni, M. A. (2001). Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. American Journal of Surgery, 182(1), 6-9. https://doi.org/10.1016/S0002-9610(01)00665-1

Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. / Livingston, David H.; Lavery, Robert F.; Passannante, Marian R.; Skurnick, Joan H.; Baker, Stephen; Fabian, Timothy; Fry, Donald E.; Malangoni, Mark A.

In: American Journal of Surgery, Vol. 182, No. 1, 06.09.2001, p. 6-9.

Research output: Contribution to journalArticle

Livingston, DH, Lavery, RF, Passannante, MR, Skurnick, JH, Baker, S, Fabian, T, Fry, DE & Malangoni, MA 2001, 'Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy', American Journal of Surgery, vol. 182, no. 1, pp. 6-9. https://doi.org/10.1016/S0002-9610(01)00665-1
Livingston, David H. ; Lavery, Robert F. ; Passannante, Marian R. ; Skurnick, Joan H. ; Baker, Stephen ; Fabian, Timothy ; Fry, Donald E. ; Malangoni, Mark A. / Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. In: American Journal of Surgery. 2001 ; Vol. 182, No. 1. pp. 6-9.
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