Diagnosis of intraperitoneal injuries in patients with pelvic fractures

It is difficult to diagnose blunt abdominal trauma in unstable patients with pelvic fractures. In the United States the standard diagnostic procedures for these patients were the physical examinations and diagnostic peritoneal lavages. However, abdominal echograms were prevalent in Europe and Japan. We reviewed 60 patients suspected blunt abdominal trauma in 804 pelvic fractures in the past four years. Eighteen DPLs and twenty-five abdominal echograms were done separately. Sensitivity, specificity, and accuracy were 100%, 40%, 66% for DPL and 94.7%, 50%, 84% for abdominal echograms respectively. Besides the better correlation with the results for echogram, it provides easy availability, noninvasiveness, and imaging function. Thus we recommend that the echogram be the first-line screening test DPL acts as a complementary test, especially in the cases of bowel perforation.