First one with correct answer with justification win.

 

A 10 year old present to your emergency department having been a back seat belted passenger involved in a motor vehicle collision (MVC). He complains of abdominal pain and has a 'seat belt sign'. The remainder of your exam is normal and his vital signs are stable other than mild tachycardia. His Hgb is 11 g/dl. An abdominal CT scan shows a moderate amount of fluid in the pelvis with no clear evidence of solid organ injury. He remains hemodynamically stable but continues to complain of mid abdominal pain.

 

The next best step in managing this patient with blunt abdominal trauma is:

 

[size=20px]A check amylase and lipase

 

B serial observation

 

C laparotomy

 

D laparoscopy

 

E peritoneal lavage[/size]

A

think again my friend

D

Correct :)

whats the rational behind laparoscopy ??

blunt trauma + hemodynamically stable + moderate collection = conservative

but presence of persistent abdominal pain need exploration with the least invasive approach aka laparoscopy

possibilities : nothing ? diaphragmatic injury ? Pancreatic injury ? concealed gut injury