Morbidity of a negative finding at laparotomy in abdominal trauma

Although it is undesirable to perform an unneeded laparotomy in patients with abdominal trauma, it is more serious to delay exploration and incur morbidity or mortality. Because a negative finding at laparotomy has a low incidence of complications, early exploration is justified in instances in which intra-abdominal injury is suspected. Although peritoneal lavage for blunt trauma and selective exploration for some stab wounds may reduce the incidence of unnecessary laparotomies, the high incidence of major injury associated with gunshot wounds precludes use of selective exploration as a reasonable policy.