Blunt abdominal trauma: Back to clinical judgement in the era of modern technology

Abstract Background and methods Abdominal trauma poses a diagnostic challenge to most trauma surgeons. This study evaluates a clinical scoring system in 476 blunt abdominal trauma patients treated by the author over a period of 92 months. Patients were sorted into three groups according to the score results. Priority I group (160 patients) was subjected to an immediate laparotomy. Priority II group (200 patients) was treated according to the results of auxiliary investigations. Priority III group (116 patients) was kept under observation. The treatment outcome was used as a gold standard for the evaluation of the results. Results In priority I and III groups (276 cases) the management was only dependent on the proposed clinical score with a 100% specificity, 88% sensitivity, 90% positive predictive value, 100% negative predictive value and an overall accuracy of 94%. Conclusions This scoring system (CASS) is helpful in ensuring rapid diagnosis and treatment, reduces time, costs and mortality that may result from improper and/or delayed diagnosis.