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Abdominal CT versus DPL

OVERVIEW

  • DPL has be replaced by FAST scan in nearly all situations
  • penetrating abdominal injuries -> require laparotomy
123
CTDPL
Indications
  • unconscious patient
  • equivocal signs
  • not requiring urgent surgery
  • as for CT
  • if CT unavailable
  • if patient unstable
  • if patient requires urgent neurosurgery
Advantages
  • non-invasive
  • information on whole abdomen
  • defines organs involved
  • sensitive to mesenteric bleeding and bowel perforation
  • bed-side test
Disadvantages
  • remote location
  • takes time, can distract, cost
  • less sensitive for injury to diaphragm, small bowel and mesentery
  • equivocal rtesults
  • false positive with pelvic #
  • misses retroperitoneal bleed
Contraindications
  • should not delay
  • unstable patient
  • other priorities
  • FAST scan available
  • previous abdominal surgery
Complications
  • contrast related
  • haemorrhage
  • bowel perforation
CCC 700 6

Critical Care

Compendium

…more CCC

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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