Multiple Diagnostic Methods Together For Intra Abdominal Injuries Must Be For Ideal Diagnosis

Introduction : Trauma is the most common cause of death during the first four decades of life ,abdominal trauma is the 3rd most common injured region (1).Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups ,clinical examination may not be helpful in the evaluation of trauma patients especially of associated co morbidity (2).Carefully performed physical examination remains the most important method to determine the need for exploratory laparotomy, there is little evidence to support this tenet, So the use of diagnostic tools in the management of injured patient with abdominal trauma is essential especially if associated with another injuries(3) . Aim of the work: Increase the accuracy of diagnosis of cases of abdominal trauma. Patients and methods: we review records of 62 abdominal trauma patients presented to emergency department in Zagazig University Hospital in the period between April 2013 to April 2014.we divide the patients in two groups , one group with abdominal trauma only and another group with abdominal trauma with associated co morbidities. Comparison had done between two groups such as , type and mechanism of injuries, mental status at presentation ,physical examinations, diagnostic modalities, and need for surgical intervention, and at the end we compare discrepancy between physical examination findings and final diagnosis . Results: we record 62 abdominal trauma patients we divide patients in two groups. group I 26 (42%) abdominal trauma with associated injuries and group II 36 (58%) abdominal trauma only .associated injuries for group I was 10 patients with head injuries,8 patients with pelvic bone fracture ,4 patients with shift fracture of hip bone,2 patients with upper humorous fracture and 2 patients with rib fracture. Conservative management was done for 15% of patients in group I and in 22% in patients in group II .Signs of abdominal injuries by physical examinations was positive in 15% in group I and in 72% in group II. So there is a significant difference in two groups .2 deaths was in group I versus all patients survive in group II. Conclusion: physical examination alone unreliable and misleading in patients with abdominal trauma with associated injuries .and the use of multiple diagnostic tools is mandatory.