Blunt Abdominal trauma: clinical aspects and diagnostic-therapeutic strategies

Blunt abdominal traumas are caused by road accidents, work accidents, falls, assault and sporting activities. They may involve only the abdominal wall or deep organs (solid organs or hollow viscera, arterial or venous vessels). The most dangerous consequences are hypovolemia and peritonitis. Diagnostic investigations include laboratory tests, standard radiology, ultrasonography, diagnostic peritoneal lavage, C.T. scan, angio-C.T. and laparoscopy. Recently, the spread of ultrasound and C.T. in emergency departments has reduced the time to determine the number and the grade of abdominal lesions to only a few minutes, making the decision between an immediate surgical treatment and a conservative approach, with monitoring of clinical, laboratory and radiologic data of the patient, easier and quicker. With the aim of making the approach of the surgeons working in the same emergency department of making homogeneous and, at the same time, of shortening the diagnostic-therapeutic procedures of the patient with a blunt abdominal trauma, a decisional algorithm, of easy and prompt consultation, is presented. Finally, techniques of damage control surgery as well as the modalities of surgical repair and resections to treat different lesions of the abdominal organs are described