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  • Title: Incidence and significance of free fluid on abdominal computed tomographic scan in blunt trauma.
    Author: Brasel KJ, Olson CJ, Stafford RE, Johnson TJ.
    Journal: J Trauma; 1998 May; 44(5):889-92. PubMed ID: 9603094.
    Abstract:
    OBJECTIVE: To determine the incidence and significance of free fluid on abdominal CT in blunt trauma. DESIGN: Retrospective chart review. METHODS: All blunt trauma patients with an abdominal computed tomographic scan from August of 1993 to December of 1995 were identified from the trauma registry at a Level 1 trauma center. A total of 1,159 computed tomographic scans were performed; records of 18 patients were excluded for incomplete records. Official reports of computed tomographic scans were reviewed for free fluid, solid organ injury, bladder injury, and pelvic fracture. RESULTS: Free fluid without solid organ injury was found in 3% (34 of 1141). Laparotomy was performed because of free fluid in 13 patients. There were six small bowel injuries and one diaphragm injury for a therapeutic laparotomy rate of 54%. Ten patients had trace free fluid and did not undergo laparotomy; none had a missed small bowel injury. CONCLUSIONS: The presence of more than trace amounts of free fluid without solid organ injury in patients with blunt trauma is a strong indication for exploratory laparotomy. Patients with isolated trace amounts of free fluid can be safely observed.
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