Abstract | BACKGROUND: Numerous studies advocate the use of diagnostic laparoscopy (DL) for abdominal trauma, but none have documented its ability to diagnose specific injuries. This study tests the hypothesis that DL can accurately identify all significant intra- abdominal injuries in trauma patients. METHODS: RESULTS: Of these, 14 patients had no significant injuries necessitating operative intervention noted at laparoscopy and celiotomy. The remaining 33 patients harbored 93 significant injuries at laparotomy, of which only 57.0% were found by DL. DL possessed poor sensitivity (<50%) for injuries to hollow viscera. Despite DL's poor performance in finding specific injuries, it possessed excellent sensitivity (96.2%), and specificity (100%) for determining the need for therapeutic celiotomy. CONCLUSIONS: DL offers no clear advantage over diagnostic peritoneal lavage and computed tomography in blunt trauma. Its utility lies in assessment of the need for laparotomy in patients with penetrating wounds. Currently, DL cannot consistently identify all abdominal injuries, disqualifying it as a therapeutic tool in abdominal trauma.
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Authors | D C Elliott, A Rodriguez, M Moncure, R A Myers, W Shillinglaw, F Davis, A Goldberg, K Mitchell, D McRitchie |
Journal | International surgery
(Int Surg)
1998 Oct-Dec
Vol. 83
Issue 4
Pg. 294-8
ISSN: 0020-8868 [Print] Italy |
PMID | 10096745
(Publication Type: Journal Article)
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Topics |
- Abdominal Injuries
(diagnosis, surgery)
- Adult
- Female
- Humans
- Laparoscopy
- Laparotomy
- Male
- Predictive Value of Tests
- Prospective Studies
- Sensitivity and Specificity
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