BACKGROUND: To compare the evaluation of the abdominal cavity by videolaparoscopic and laparotomic methods, in patients sustaining abdominal trauma. METHOD: From November of 2001 to February of 2002, 25 patients were studied, being 21 males and four females. Average age was 30.88 years, varying from 18 to 63. The videoendoscopic evaluation was carried through in a standardized and sequential form. After that, all the patients were laparotomised and the evaluation remade with the same criteria. Abdominal structures and viscera were classified as visualized, partially visualized, not visualized and non-existent. RESULTS: In videolaparoscopic evaluation, the left lobe of the liver, the diaphragmatic domes, the gallbladder, the posterior wall of the bladder, anterior Douglas' cul-de-sac and the internal face of the abdominal wall were fully visualized in all cases. The others intra-abdominal structures and viscera were completely visualized in percentages that varied from 25% to 76%. Videolaparoscopic evaluation presented sensitivity of 45.45%, specificity of 100%, positive predictive value of 100% and negative predictive value of 20%. Laparotomic evaluation identified 78 injuries and videolaparoscopy 56. CONCLUSIONS: Videolaparoscopic evaluation in abdominal trauma is not effective in the visualization and diagnosis of intra-abdominal injuries. However it is sufficiently trustworthy in cases of doubts of penetration of the abdominal cavity, in the diagnostic of diaphragmatic and toraco-abdominal injuries and to exclude injuries of the anterior esophagus, stomach and duodenum wall, posterior wall of the bladder and gallbladder.
Trauma; Abdomen; Laparoscopy; Videolaparoscopy
