Which test do we use for Abdominal Trauma?

In most cases, the need for operation is obvious following abdominal trauma.  Occasionally, however, the indication is not clear. 
The exam may be:

• unreliable (head or spinal injury),
• equivocal (wound pain or nearby fractures),
• or simply unavailable (general anesthesia for associated injuries)

In these cases, it may be necessary to rely on ancillary diagnostic testing. The choices are:

• Diagnostic Peritoneal Lavage - invasive and takes time, best test for penetrating trauma
• Computed Tomography - yields qualitative information but requires move to scanner, best test for stable blunt trauma, not proven in penetrating trauma except back/flank
• Focused Assessment with Sonography for Trauma - rapid, operator dependant, requires additional training - good for unstable blunt trauma, not sensitive enough for penetrating trauma

DPL – Invasive, takes time
  - for penetrating trauma

FAST – rapid, operator dependant
  - for unstable blunt trauma

CT – qualitative, requires move to scanner
  - for stable blunt trauma