Blunt and penetrating trauma - Has anything changed?

The epidemiology, diagnosis and therapy of abdominal injuries have changed. More injuries are inflicted by the bullet and less by the auto. The ultrasound machine in the hands of the non-radiologist and the CT scanner have nearly replaced the diagnostic peritoneal lavage as the means to assess the abdomen for injury. Liver injuries from both blunt and penetrating mechanisms are being managed non-operatively and colon injuries are managed without colostomy. The survival of patients with massive abdominal injury is improved with staged laparotomy and a better understanding of the negative physiologic consequences of increased intra-abdominal pressure.