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Medline ® Abstract for Reference 7

of 'Emergency ultrasound in adults with abdominal and thoracic trauma'

Focused abdominal US in patients with trauma.
Lingawi SS, Buckley AR
Radiology. 2000;217(2):426.
PURPOSE: To evaluate the accuracy of focused abdominal ultrasonography (US) in detecting abdominal injuries that require in-hospital patient treatment in the setting of blunt abdominal trauma.
MATERIALS AND METHODS: One thousand ninety patients with blunt abdominal trauma were assessed with focused abdominal US within 30 minutes of arrival at the hospital. Focused abdominal US results were positive if intra- or retroperitoneal fluid was detected. Patients with negative US results and no other major injuries were observed in the emergency department for 12 hours before discharge. Patients who deteriorated clinically after negative initial US underwent repeat US and/or emergency abdominopelvic computed tomography (CT). Patients with positive or indeterminate US results underwent emergency abdominopelvic CT.
RESULTS: Nine hundred seventy-four (89%) patients had negative focused abdominal US results; eight of these underwent CT. Sixty-six (6%) had positive US results. Four (0.4%) had false-negative and 19 (1.7%) had false-positive US results. Twenty-seven (2.5%) had indeterminate US results; of these, five (18.5%) had positive CT results. One hundred twenty-four (11.4%) required emergency CT. After indeterminate cases were excluded, focused abdominal US had 94% sensitivity, 98% specificity, 78% positive predictive value, 100% negative predictive value, and 95% accuracy.
CONCLUSION: Focused abdominal US has a high negative predictive value for major abdominal injury in patients with blunt abdominal trauma.
Department of Radiology, Vancouver Hospital and Health Science Center, Vancouver, BC, Canada. tersam2@yahoo.com