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Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXIX: Wounds of the Abdomen

Initial Evaluation

United States Department of Defense
Peer Review Status: Internally Peer Reviewed


The goal of the initial evaluation is to allow the surgeon to determine the probability of an intra-abdominal injury. There is no overriding need for a more specific diagnosis. There are no clearly defined minimally acceptable standards for success. The surgeon must simply do the best that he can for the most patients under the existing circumstances. The "best" is defined as no missed intra-abdominal injuries with the fewest possible negative exploratory laparotomies.

The combat surgeon can consistently achieve this goal by consciously taking four actions. These actions are systematic evaluation of the patient, classification of the patient, consideration of extenuating circumstances, and preparation for operation. Each of these acts is of equal importance. They must be performed simultaneously.

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