Negative laparotomy in trauma: are we getting better?

One of the trauma surgeons' daily challenges is the balancing act between negative laparotomy and missed abdominal injury. We opted to characterize the indications that prompted a negative trauma exploratory laparotomy and the rate of missed abdominal injuries in an effort to optimize patient selection for laparotomy. At the Los Angeles County + University of Southern California Medical Center, negative laparotomies and missed injuries are consecutively captured and reviewed at the weekly mortality + morbidity (MM) conferences.

Current practice and the role of the CT in the management of penetrating liver injuries at a Level I trauma center.

Background: The liberal utilization of computed tomography (CT) has significantly contributed to overall improvements in trauma care. However, the role and the current practice of the CT examinations in the management of patients with penetrating liver injuries are scantily documented.

Aims: This study was aimed to assess the current practice and the role of the admission and follow-up CT in patients with penetrating liver injuries.

Clinical examination is insufficient to rule out thoracolumbar spine injuries.

Purpose: The role of clinical examination in the diagnosis of thoracolumbar (TL) spine injuries is highly controversial. The aim of this study was to assess the sensitivity and specificity of a standardized clinical examination for diagnosing TL spine injuries after blunt trauma.

Methods: This was a prospective observational study conducted at a level I trauma center from March 2008 to September 2008.