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Emerg Med Clin North Am. 1999 Feb;17(1):63-75, viii.

Evaluation of the patient with blunt abdominal trauma: an evidence based approach.

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Division of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.


Patients with blunt abdominal trauma present a special challenge to the emergency physician. Physical examination is often unreliable, even if the patient is awake, and the frequent co-existence of head injury exacerbates this problem. This article examines the evidence basis of three diagnostic modalities in evaluating blunt abdominal trauma: DPL (the time-honored test); CT scanning (the current standard of care); and abdominal sonography (the emerging standard--especially for examination conducted in the trauma room). A proposed algorithm for the appropriate use of these modalities is also presented.

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