Trauma To The Flank And Buttocks

Question 1

Sensitive and specific for injury of peritoneal and retroperitoneal organs Useful for ascertaining injury path

Can miss diaphragmatic injury or colon injuries
Oral/rectal contrast, time consuming

Answer 1

CT

Question 2

Rapid, portable, noninvasive
Sensitive and specific for hemopericardium and intraperitoneal fluid

Not sensitive for retroperi- toneal or hollow viscous injuries Insufficient to rule out specific organ injury

Answer 2

Ultrasound

Question 3

Sensitive for intraperitoneal injury

Invasive, high false-positive rate
Unable to detect diaphragmatic or retroperitoneal injuries

Answer 3

Diagnostic peritoneal lavage

Question 4

Sensitive for peritoneal violation in abdominal trauma when technically adequate

Limited utility in flank/ back due to no discernable fascial planes. Can lead to nontherapeutic laparotomy

Answer 4

Local wound exploration

Question 5

Highly sensitive and specific for peritoneal and diaphragmatic injury6 Can avoid unnecessary laparotomy

Invasive
Not as sensitive for retro- peritoneal injury

Answer 5

Laparoscopy

Question 6

imaging modality of choice in hemodynamically stable patients with penetrating flank trauma

Answer 6

CT

Question 7

is indicated for patients who are hemodynamically unstable or who exhibit peritoneal signs after sustaining a penetrating wound to the flank

Answer 7

Exploratory laparotomy