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April 1, 1983

Diagnosis of Trauma

Author Affiliations

University of Mississippi Medical Center Jackson

JAMA. 1983;249(13):1708-1709. doi:10.1001/jama.1983.03330370022015

To the Editor.—  In reference to a question regarding potential complications after injuries sustained by a patient in a vehicular accident (QUESTIONS AND ANSWERS, 1982;248:1510), we offer the following comments. As stated by Dr Ben Eiseman, injuries to the thorax and abdomen by hitting against the steering wheel may cause substantial intrathoracic and intraabdominal trauma in a patient who may exhibit stable clinical status and normal vital signs.The potential injuries cited included rupture of the liver or spleen, traumatic rupture of the diaphragm, severed subclavian artery, ruptured aorta, and pulmonary and myocardial contusions. All of these injuries are fraught with the potential of serious consequences if not recognized and treated. One would like either to document or rule out the presence of these injuries in the least invasive manner and in as short a duration as possible.Depending on the available facilities at the treatment center, a combination of