[Closed abdominal injuries in patients with multiple injuries. Diagnostic considerations on 74 cases]

A diagnostic assessment was made of 74 cases of non-penetrating abdominal wounds observed over the previous 5 years. Laparoscopy performed in 49 polytraumatised patients made a decisive contribution to accurate, early diagnosis, with an indication for emergency surgery in 35 cases (32 visceral lesions and 3 retroperitoneal haematoma), whereas it was clear from the negative finding that surgery was not required in the remaining 14. It is felt that all additional radiological and instrumental diagnostic should be employed, and that careful clinical examination and repeated inspection, preferably by the same surgeon, are important in cases of multiple injury, since the situation may become dramatically worse in the space of a few hours.