ABSTRACT
Intra-abdominal blood loss and/or hollow viscus perforation with peritoneal contamination remains the leading cause of preventable morbidity and mortality in the trauma patient. The specific mechanism of injury coupled with abnormal physical findings (such as guarding, rebound tenderness, ileus, and abdominal distension) may suggest a high likelihood of intra-abdominal injury, and the need for emergency laparotomy in the awake, cooperative patient. However, many trauma patients present with confounding factors which render the abdominal physical examination unreliable (Table 79.1). Consequently, additional diagnostic studies are often required to rule out significant intra-abdominal injuries in this patient population. Diagnostic peritoneal lavage (DPL) continues to be extensively used for this purpose.
