Medline ® Abstract for Reference 9
of 'Emergency ultrasound in adults with abdominal and thoracic trauma'
2,576 ultrasounds for blunt abdominal trauma.
Dolich MO, McKenney MG, Varela JE, Compton RP, McKenney KL, Cohn SM
J Trauma. 2001;50(1):108.
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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%.
CONCLUSION: 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.
Section of General Surgery/Trauma, University of Arizona Health Sciences Center, Tucson, Arizona, USA.