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Free intraperitoneal (IP) fluid on abdominal CT without other apparent injury may indicate significant bowel or mesenteric pathology. This retrospective study from University Medical Center in Fresno, California, asked whether this finding dictates laparotomy.
Trauma registry data revealed 798 patients who had standard abdominal CT scans using intravenous (2 ml/kg) and oral (10 ml/kg) contrast. Initial readings by the chief surgical resident or trauma fellow identified solid-organ injury in 78 (10%), extraperitoneal injury in 17 (2%), and free IP fluid without apparent injury in 31 (4%). All 31 patients with isolated IP fluid underwent laparotomy, which revealed small bowel or colon injuries in 18 (58%), major mesenteric injury in 8 (26%), i…