Evaluation of the abdomen in intoxicated patients

Is computed tomography scan or peritoneal lavage always indicated?

Felix Garcia Perez, Keith F. O'Malley, Steven E. Ross

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Study objective: To investigate the necessity of intensive evaluation of the intoxicated patient with normal mentation for intra-abdominal injury after blunt torso trauma. Design: Retrospective study; trauma registry and medical records. Setting: Level I regional trauma center serving a population of 2.3 million. Participants: Adult victims of blunt trauma more than 17 years old, admitted between January 1, 1986, and December 31, 1989, with suspected blunt abdominal injury and serum ethanol of more than 100 mg/dL and Glasgow Coma Score of 15. Intervention: All patients had serum ethanol levels measured in mg/dL and computed tomography (CT) scan of the abdomen and/or diagnostic peritoneal lavage (DPL). Results: Criteria were met by 92 patients. Eighty-nine underwent CT scans, two had DPL, and one had both. Of 17 patients complaining of abdominal pain and/or tenderness on palpation, six (35.3%) had blood in the peritoneal cavity demonstrated by CT scan or DPL and underwent celiotomy All 75 patients without abdominal pain or tenderness had negative CT scan or DPL, with no missed injury. Conclusion: In the intoxicated blunt trauma patient with normal mentation, the physical examination is a reliable indicator of abdominal injury. Elevated alcohol level; per se, should not be considered an absolute indication for DPL or abdominal CT.

Original languageEnglish (US)
Pages (from-to)500-502
Number of pages3
JournalAnnals of Emergency Medicine
Volume20
Issue number5
DOIs
StatePublished - Jan 1 1991
Externally publishedYes

Fingerprint

Peritoneal Lavage
Abdomen
Tomography
Abdominal Injuries
Wounds and Injuries
Abdominal Pain
Ethanol
Torso
Nonpenetrating Wounds
Palpation
Trauma Centers
Peritoneal Cavity
Coma
Serum
Physical Examination
Medical Records
Registries
Retrospective Studies
Alcohols
Population

Keywords

  • intoxication, trauma
  • trauma, blunt, abdominal

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Evaluation of the abdomen in intoxicated patients : Is computed tomography scan or peritoneal lavage always indicated? / Perez, Felix Garcia; O'Malley, Keith F.; Ross, Steven E.

In: Annals of Emergency Medicine, Vol. 20, No. 5, 01.01.1991, p. 500-502.

Research output: Contribution to journalArticle

@article{32773e500f68405f8999c7e9112e99c0,
title = "Evaluation of the abdomen in intoxicated patients: Is computed tomography scan or peritoneal lavage always indicated?",
abstract = "Study objective: To investigate the necessity of intensive evaluation of the intoxicated patient with normal mentation for intra-abdominal injury after blunt torso trauma. Design: Retrospective study; trauma registry and medical records. Setting: Level I regional trauma center serving a population of 2.3 million. Participants: Adult victims of blunt trauma more than 17 years old, admitted between January 1, 1986, and December 31, 1989, with suspected blunt abdominal injury and serum ethanol of more than 100 mg/dL and Glasgow Coma Score of 15. Intervention: All patients had serum ethanol levels measured in mg/dL and computed tomography (CT) scan of the abdomen and/or diagnostic peritoneal lavage (DPL). Results: Criteria were met by 92 patients. Eighty-nine underwent CT scans, two had DPL, and one had both. Of 17 patients complaining of abdominal pain and/or tenderness on palpation, six (35.3{\%}) had blood in the peritoneal cavity demonstrated by CT scan or DPL and underwent celiotomy All 75 patients without abdominal pain or tenderness had negative CT scan or DPL, with no missed injury. Conclusion: In the intoxicated blunt trauma patient with normal mentation, the physical examination is a reliable indicator of abdominal injury. Elevated alcohol level; per se, should not be considered an absolute indication for DPL or abdominal CT.",
keywords = "intoxication, trauma, trauma, blunt, abdominal",
author = "Perez, {Felix Garcia} and O'Malley, {Keith F.} and Ross, {Steven E.}",
year = "1991",
month = "1",
day = "1",
doi = "10.1016/S0196-0644(05)81602-6",
language = "English (US)",
volume = "20",
pages = "500--502",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Evaluation of the abdomen in intoxicated patients

T2 - Is computed tomography scan or peritoneal lavage always indicated?

AU - Perez, Felix Garcia

AU - O'Malley, Keith F.

AU - Ross, Steven E.

PY - 1991/1/1

Y1 - 1991/1/1

N2 - Study objective: To investigate the necessity of intensive evaluation of the intoxicated patient with normal mentation for intra-abdominal injury after blunt torso trauma. Design: Retrospective study; trauma registry and medical records. Setting: Level I regional trauma center serving a population of 2.3 million. Participants: Adult victims of blunt trauma more than 17 years old, admitted between January 1, 1986, and December 31, 1989, with suspected blunt abdominal injury and serum ethanol of more than 100 mg/dL and Glasgow Coma Score of 15. Intervention: All patients had serum ethanol levels measured in mg/dL and computed tomography (CT) scan of the abdomen and/or diagnostic peritoneal lavage (DPL). Results: Criteria were met by 92 patients. Eighty-nine underwent CT scans, two had DPL, and one had both. Of 17 patients complaining of abdominal pain and/or tenderness on palpation, six (35.3%) had blood in the peritoneal cavity demonstrated by CT scan or DPL and underwent celiotomy All 75 patients without abdominal pain or tenderness had negative CT scan or DPL, with no missed injury. Conclusion: In the intoxicated blunt trauma patient with normal mentation, the physical examination is a reliable indicator of abdominal injury. Elevated alcohol level; per se, should not be considered an absolute indication for DPL or abdominal CT.

AB - Study objective: To investigate the necessity of intensive evaluation of the intoxicated patient with normal mentation for intra-abdominal injury after blunt torso trauma. Design: Retrospective study; trauma registry and medical records. Setting: Level I regional trauma center serving a population of 2.3 million. Participants: Adult victims of blunt trauma more than 17 years old, admitted between January 1, 1986, and December 31, 1989, with suspected blunt abdominal injury and serum ethanol of more than 100 mg/dL and Glasgow Coma Score of 15. Intervention: All patients had serum ethanol levels measured in mg/dL and computed tomography (CT) scan of the abdomen and/or diagnostic peritoneal lavage (DPL). Results: Criteria were met by 92 patients. Eighty-nine underwent CT scans, two had DPL, and one had both. Of 17 patients complaining of abdominal pain and/or tenderness on palpation, six (35.3%) had blood in the peritoneal cavity demonstrated by CT scan or DPL and underwent celiotomy All 75 patients without abdominal pain or tenderness had negative CT scan or DPL, with no missed injury. Conclusion: In the intoxicated blunt trauma patient with normal mentation, the physical examination is a reliable indicator of abdominal injury. Elevated alcohol level; per se, should not be considered an absolute indication for DPL or abdominal CT.

KW - intoxication, trauma

KW - trauma, blunt, abdominal

UR - http://www.scopus.com/inward/record.url?scp=0025764028&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025764028&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(05)81602-6

DO - 10.1016/S0196-0644(05)81602-6

M3 - Article

VL - 20

SP - 500

EP - 502

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 5

ER -