الفهرس 
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Abstract
The study was carried out on 40 patients sustaining blunt abdominal trauma and presenting to the surgical emergency at Alexandria Main University Hospital to evaluate:
1. The efficacy of clinical examination, Focused Assessment of Sonography in Trauma (FAST) and abdominal Computed Tomography (CT) in the diagnosis of intra abdominal injury in blunt abdominal trauma.
2. Safety of non operative management among those 40 patients suffering from intra abdominal injury due to blunt trauma.
These 40 patients selected according to the inclusion criteria to undergo non operative management which includes:
Patients who were hemodynamically stable and who had no peritoneal signs (pneumoperitonium) were assigned to non-operative treatment.
Unstable patient (hypotension <90 mmHg and tachycardia >100 b/min) who showed hemodynamic improvement with rapid administration of 2.000 ml of intravenous fluids (responders to fluid challenge test).
These patients were submitted to initial evaluation for life threatening injuries and presence of hypovolemia and shock and given the necessary resuscitation (2L of fluid and blood transfusion if needed) then necessary laboratory investigations were performed. In addition, complete physical examination was done as regard to head, neck, abdomen, pelvic, perineal, rectal and vaginal examination.
Revised Trauma Score was used for every patient to assess the severity of the injury. FAST was done to all patients then CT abdomen for better evaluation and grading of the injury or presence of additional injuries.
Non operative management was applied to those selected patients in the form of medical treatment and strict observation of blood transfusion, fluid replacement, complications and rate of conversion to exploration.
The age of our patients ranged from 5-48 years, 23 were males and17 were females and road traffic accidents were the main mechanism of trauma (24 patients). The majority of patients (25) presented with only elicited area of tenderness,14 patients with abdominal rigidity and 1 patient with no abnormal signs. As regard stability, there were 30 stable patients and 10 unstable patients.
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