Isolated Free Fluid on Abdominal CT Imaging in Blunt Trauma: Operative Exploration or Observation?

To determine if operative exploration or observation is the preferred management for hemodynamically stable blunt trauma patients with isolated free fluid on abdominal computed tomography (CT) imaging, researchers reviewed the management and outcomes for 156 such patients admitted to a level 1 trauma center in California from 2009 to 2012. All patients were 16 years or older and had no peritoneal signs on examination, no evidence of solid organ or hollow viscous injury on CT imaging, and no history of cirrhosis.

Most patients (91%) were successfully managed nonoperatively. Ten patients underwent immediate operative exploration and were diagnosed with intraperitoneal bladder injury (4), ruptured ovarian cyst (1), mesenteric laceration (1), me…