Penetrating wounds of the abdomen imply underlying visceral damage, and surgical intervention is clearly indicated. Nonpenetrating abdominal injuries are equally lethal, but the seriousness of the injury may be underestimated. In the absence of visible signs of injury to the abdominal wall, the blunt force may be considered insufficient to produce visceral injury. Associated injuries may distract attention from the less obvious abdominal symptoms. A significant number of patients may have no pain or shock on admission to the hospital.1If an associated injury should require an emergency procedure, general anesthesia may mask the developing abdominal signs for many hours.2 The alarming increase in mortality resulting from delayed operation is pointed out in many reports.* These observations prompted us to study the nonpenetrating abdominal injuries at St. Luke's Hospital for the years 1940 to 1954. The records of 47 patients were studied. Table 1 presents the distribution of