Ultrasonography in the evaluation of hemoperitoneum in war casualties

• Published in: Military medicine Vol. 164; no. 8; pp. 600 - 602
• Main Authors: SUSTIC, A, MILETIC, D, FUCKAR, Z, MRAOVIC, B, DIMEC, D, MOZETIC, V
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Association of Military Surgeons 01.08.1999; Oxford University Press
• Subjects: Abdominal Injuries - complications; Adolescent; Adult; Biological and medical sciences; Digestive system. Abdomen; Emergencies; Female; Hemoperitoneum - diagnostic imaging; Hemoperitoneum - etiology; Hospitals, Military; Hospitals, University; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Military Medicine - methods; Military Personnel; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Ultrasonic investigative techniques; Ultrasonography; Warfare; Yugoslavia; Europe; Croatia; Sonography; Human; Hemoperitoneum; Effusion; War; Sensitivity; Specificity; Abdominal disease; Echography; Predictive value; Diagnosis; Comparative study; Peritoneum
• ISSN: 0026-4075; 1930-613X
• DOI: 10.1093/milmed/164.8.600

The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions.