Abdominal injuries in automobile accidents: review of care of fatally injured patients.

Hypovolemia continues to be an important cause of death in patients who die as a result of vehicular trauma. Diagnosis and treatment of a series of 127 patients who died with blunt abdominal trauma from automobile accidents during 1969-1974 in Vermont are reported. The most frequent errors in the cases reviewed were failure to recognize and adequately treat hypovolemia, and to appreciate the urgent need for surgery. Death on the X-ray table while allowing persistence of hypovolemia was the common denominator in four of the five victims who died of ruptured spleens in the emergency departments, after having arrived alive following vehicular trauma. Forty-seven per cent of all reported deaths in automobile accidents had blunt abdominal trauma. Of those with blunt abdominal trauma who arrived alive, 26% might have survived with appropriate treatment which should have been available.