Twenty-nine patients had a total of thirty-five different injuries from blunt abdominal trauma. The predominant injuries were of the solid abdominal organs. The injuries occurred predominantly in men, while the type of trauma and injuries in women paralleled those in the men. Clinical signs of peritoneal irritation and blood loss were important in indicating the need for laparotomy. Additional aids in diagnosis included blood on peritoneal tap, abdominal roentgenograms for fluid, intravenous pyelogram showing distortion, decreasing serial hematocrits and presence of trauma or fractured ribs overlying the spleen or kidney. Twenty-one patients were treated surgically and two died postoperatively, both of whom had multiple injuries. Eight patients were treated with nonoperative means, six of these having a contused kidney. One patient died of a delayed rupture of the spleen complicated by a head injury and fractured legs. Patients with blunt abdominal trauma present difficult diagnostic problems, aided sometimes by roentgenogram or laboratory tests. Treatment is contingent upon accurate diagnosis and is complicated by multiple injuries.
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