Isolated Free Fluid without Pneumoperitoneum on Computed Tomography in Blunt Abdominal Trauma: Laparotomy Better Based on Imaging Finding and Clinical Presentation

This study examines the clinical assessment and management of patients sustaining blunt abdominal trauma (BAT) with unexplained intra-abdominal free fluid.All adult patients (age 18 years) presenting with BAT to our trauma center over a 7-year period were reviewed.

Those with abdominal computed tomography (CT) demonstrating intra-peritoneal free fluid but neither solid organ injury nor pneumoperitoneum were studied further. Demographic data, radiologic interpretation, operative findings, clinical management and outcome were analyzed.

115 patients met the inclusion criteria. Except 9 patients for non-operative management, 91 patients (86%) underwent therapeutic laparotomy, in whom 83 patients (78%) benefited from surgical intervention and 15 patients (14%) underwent non-therapeutic laparotomy, in whom 8 patients (8/15=53%) had retroperitoneal hematoma with associated pelvic fractures.

PDF LINK