2,576 ultrasounds for blunt abdominal trauma

• Published in: The journal of trauma Vol. 50; no. 1; p. 108
• Main Authors: Dolich, M O, McKenney, M G, Varela, J E, Compton, R P, McKenney, K L, Cohn, S M
• Format: Journal Article
• Language: English
• Published: United States 01.01.2001
• Subjects: Abdominal Injuries - diagnostic imaging; Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies; Ultrasonography
• ISSN: 0022-5282; 1529-8809
• DOI: 10.1097/00005373-200101000-00019

Determination of intra-abdominal injury following blunt abdominal trauma (BAT) continues to be a diagnostic challenge. Ultrasound (US) has been described as a potentially useful diagnostic tool in this setting and is being used with increasing frequency in trauma centers. We determined the diagnostic capability of US in the evaluation of BAT. A retrospective analysis of our trauma US database was performed over a 30-month period. Computed tomographic scan, diagnostic peritoneal lavage, or exploratory laparotomy confirmed the presence of intra-abdominal injury. During the study period, 8,197 patients were evaluated at the Ryder Trauma Center. Of this group, 2,576 (31%) had US in the evaluation of BAT. Three hundred eleven (12%) US exams were considered positive. Forty-three patients (1.7%) had a false-negative US; of this group, 10 (33%) required exploratory laparotomy. US had a sensitivity of 86%, a specificity of 98%, and an accuracy of 97% for detection of intra-abdominal injuries. Positive predictive value was 87% and negative predictive value was 98%. Emergency US is highly reliable and may replace computed tomographic scan and diagnostic peritoneal lavage as the initial diagnostic modality in the evaluation of most patients with BAT.