A pt developed haemoperitoneum following A, with BP 90/60 & pulse 140/min which of the following to be done ?
Ans is 'c' i.e. USG is better than CT-Scan The aim of investigations in blunt abd. trauma is to decide whether exploratory laprotomy is to be done or not. In this pt. it's already known that he has hemoperitoneum, so there is no need of DPL. He needs an urgent laprotomy to look for injuries & manage them accordingly. USG is better than CT scan for the evaluation of blunt abd. trauma patients as U/S is easily available and performed bed side. It accurately detects the intrabdominal free fluid and that's all that is needed for the moment. It also simultaneously assesses the pleural and pericardial cavities. Though CT is more sensitive & specific and provides many additional information which cannot be assessed by U/S (like evaluation of retroperitoneum, assessment of renal perfusion) it takes time, pt. has to be shifted to CT unit, needs experienced radiologist, is much more expensive. So it is used in stable patients only for fuher evaluation after an U/S.
DPL to be done
Liver is the MC organ to rupture
USG is better than CT Scan
X-ray to be taken in supine position