The management of patients who have or may have suffered blunt abdominal trauma is often complicated by the presence of associated severe injuries, such as flail chest, head injuries, and extremity or pelvic fractures, rendering the patient relatively unresponsive to peritoneal irritation from an intra-abdominal catastrophe. The mortality of blunt abdominal trauma in most reports, including a recent communication by Perry,1 is approximately 40% to 50%. This contrasts with the 5% to 6% mortality of penetrating abdominal trauma for which abdominal exploration is done routinely. The greatest threats to the injured patient are, of course, the magnitude of total tissue damage and the number of major systems involved by this damage. We have no control over this basic problem. All that can be offered at this point is prompt and precise repair appropriate to each patient's needs.
Another threat to the injured patient is undetected visceral or vascular disruption. And