![]() The findings of peritoneal irritation are incredibly critical. Through inspection, auscultation, and palpation, the damaged organs and the presence of hemorrhage should be examined during the physical examination. Patients may remain asymptomatic until they have lost 50–60% of their blood volume. Abdominal surgery after traumatic injury is performed for two reasons bleeding due to injury to vascular structures or a solid organ (e.g., spleen, liver, kidney) or injury due to perforation of a hollow organ (stomach, small intestine, colon, gallbladder). Deaths caused by blunt trauma are frequently the result of diagnostic difficulties and treatment delays. The most important risk after trauma is hypovolemic shock. Depending on the mechanism of occurrence, abdominal traumas are classified as either blunt or penetrating. ![]() Likewise a negative likelihood ratio of 0.5 should decrease your probability of disease by 15%, 0.2 by 30% and 0.1 by 45%.Abdominal trauma accounts for 7–10% of hospital admissions due to trauma. A positive likelihood ratio of 2 should increase your probability of disease ( resulting in your post test probability) by 15%, 5 by 30% and 10 by 45%. The following image is a quick way to think about likelihood ratios. However, it also elucidates a relatively poor sensitivity of the FAST exam, making it a poor tool to "rule-out." This is important as it urges physicians to not rely solely on a negative FAST exam when ruling out intra-abdominal injury but consider other factors including clinical gestalt, mechanism of injury, physical exam and laboratory work up.Īdditionally, to better understand the magnitude of this paper's findings it is important to known what a likelihood ratio really tells us. ![]() This reinforces ultrasounds role as the best tool to "rule-in" an intra-abdominal injury. Overall, this paper reinforces the strength of bedside ultrasonography (adjusted positive LR of 30) as a diagnostic tool of intra-abdominal injury following blunt trauma compared to physical exam and laboratory findings. abdominal CT, DPL, laparotomy, autopsy, or clinical course to detect intra-abdominal injury or hemoperitoneum).
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