[Abdominal injuries in polytraumatized adults : Systematic review]

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Diagnostic Imaging

Background:

• Abdominal injuries affect 20-25% of polytraumatized patients, primarily due to blunt trauma.
• Commonly injured organs include the liver and spleen; intestinal injuries are less frequent.
• Clinical evaluation of abdominal trauma can be inconclusive.

Purpose of the Study:

• To outline the diagnostic and therapeutic strategies for abdominal injuries in polytraumatized patients.
• To emphasize the role of computed tomography (CT) in evaluating abdominal trauma.
• To define indications for surgical intervention versus conservative management.

Main Methods:

• Computed tomography (CT) is the gold standard for diagnosing abdominal injuries, even in hemodynamically unstable patients.
• Focused Assessment with Sonography for Trauma (FAST) aids in initial assessment.
• Angiography with potential embolization is a diagnostic and therapeutic tool.

Main Results:

• CT provides precise diagnostic findings crucial for guiding therapy.
• Hemodynamically unstable patients typically require exploratory laparotomy (EL).
• Conservative management is suitable for hemodynamically stable patients without peritonitis or specific severe findings.

Conclusions:

• CT is essential for accurate diagnosis and treatment planning in abdominal trauma.
• Exploratory laparotomy (EL) is indicated for unstable patients or those with specific severe injuries identified by FAST or CT.
• Conservative treatment is a viable option for stable patients without critical injury signs.