US STUDY IN BLUNT ABDOMINAL TRAUMA AT VACHIRA PHUKET HOSPITAL
Abstract
Purpose: To evaluate the accuracy of abdominal ultrasonography (US) in patients having been injured by blunt abdominal trauma.
Material and methods: A retrospective reviews of medical record and imaging of 115 patients with blunt abdominal trauma who were sent to be investigated by abdominal ultrasonography at Vachira phuket hospital from 2000 to 2005. The abdomen and pelvis were scanned for free fluid while the visceral organs were assessed for heterogeneity. Empty bladder was filled with 200-300 ml of sterile saline through a Foley catheter. U/S findings were considered positive if free fluid was presented or if parenchymal abnormalities that could be consistent with trauma were detected. US results were compared with those of the diagnostic peritoneal lavage findings, repeated US, computed tomography (CT), cystography, surgery, and/or following of the clinical courses.
Results: Findings from 115 US examinations were evaluated with the results of being positive 82 of 90 patients regarding injuries (sensitivity 91%). False negative findings were bowel injury, retroperitoneal injury, and intraperitoneal solid organ injury without hemoperitoneum. No patients with false-negative findings died from intraabdominal injury. Specificity of US was 68% (17 of 25 patients). Positive predictive value was 91% (82 of 90 patients), and negative predictive value was 68% (17 of 25 patients)
Conclusion: Abdominal US is noninvasive procedure and useful in detection of damages in patients confronted with blunt abdominal trauma.
Downloads
Metrics
References
Schurink GW, Bode PJ, van Luijt PA, van Vugt AB. The value of physical examination in the diagnosis of patients with blunt abdominal trauma: a retrospective study. Injury 1997; 28: 261-265. (Medline)
Root HD, Hauser CW, McKinley CR, et al. Diagnostic peritoneal lavage. Surgery 1965; 57: 633-638.
Wing VW, Federle MP, Morris JA, Ir, et al. The clinical aspect of computed tomography for blunt abdominal trauma. AJR Am J Roentgenol 1985; 145: 1191-1194. (Medline)
Federle MP, Jeffrey RB, Jr. Hemoperitoneum studied by computed tomography. Radiology 1983; 148: 187-192 (Abstract)
Jeffrey RB, Jr, Federle MP, Crass RA. Computed tomography of pancreatic trauma. Radiology 1983; 147: 491-494. (Abstract)
Jeffrey RB, Jr Olcott EW. Imaging of blunt hepatic trauma. Radiol Clin North Am 1991; 29: 1299-1310. (Medline)
Kinnunen J, Kivioja A, Poussa K, et al. Emergency CT in blunt abdominal trauma of multiple injury patients. Acta Radiol 1994; 35: 319- 322. (Medline)
Kristensen JK, BuemannB, Kuehl E. Ultrasonic scanning in the diagnosis of splenic hematomas. Acta Chem Scand 1971; 137: 653-657.
Hoffman R, Nerlich M, Muggia-Sullam M, et al. Bluntabdominal trauma in cases of multiple trauma evaluated by ultrasonography: a prospective analysis of 291 of multiple trauma evaluated by ultrasonography: a prospective analysis of 291 patients. J Trauma 1992; 32: 452-458. (Medline).
Rothlin MA, Naf R, Amgwerd M, et al. Ultrasound in blunt abdominal and thoracic trauma. J. Trauma 1993; 34: 488-495. (Medline)
YoshiiH, SatoM, Yamamoto §, et al. Usefulness and limitation of ultrasonography in the initial evaluation of blunt abdominal trauma. J Trauma 1998; 45: 45-51. (Medline)
Healy MA, Simons RK, Winchell RJ, et al. A prospective evaluation of abdominal ultrasound in blunt abdominal trauma: is it useful? J.Trauma 1996;40:875-883. (Medline).
McGahan JP, Rose J, Coates TL, Wisner DH, Newberry P. Use of ultrasonography in the patient with acute abdominal trauma. J Ultrasounds Med 1997;16:653-662. (Abstract)
McKenney MG, Martin L, Lentz K, etal. 1,000 consecutive ultrasounds for blunt abdominal trauma. J Trauma 1996; 40: 607-612. (Medline)
McKenney KL, Nunez DB, McKenney MG, Asher J, Zelinick K, Shipsahk D. Sonography as the primary screening technique for blunt abdominal trauma: experience with 899 patients. AJR Am J Roentgenol 1998; 170: 979-985. (Abstract)
Rozycki GS, Ochsner MG, Jaffin JH. A prospective study of surgeon-performed ultrasound as the primary adjuvant modality for injured patient assessment. J Trauma 1995; 39: 492-498. (Medline).
Rozycki GS, Ballard RB, Fellciano DV, Schmidt JA, Pennington SD. Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann. Surg 1998; 228: 557-567. (Medline)
McElveen TS, Collin GR. The role of ultrasonography in blunt abdominal trauma: a prospective study. Am. Surg 1997; 63:184- 188. (Medline).
McKenney M, Lentz K, Nuenz D, et al. Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma 1994; 37: 439-441. (Medline)
Nordenholz KE, Rubin MA, Gularte GG, Liang HK. Ultrasound in the evaluation and management of blunt abdominal trauma. Ann Emerg Med 1997; 29: 357-365. (Medline).
Chui WC, Cushing BM, Rodriguez A, etal. Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma (FAST). J Trauma 1997; 42: 617-623. (Medline).
Shanmuganathan K, Mirvis SE, Sherbourne CD, Chiu WC, Rodriguez A. Hemoperitoneum as the sole indicator of abdominal visceral injuries: a potential limitation of screening abdominal US for trauma. Radiology 1999; 212: 423-430. (Abstract/Free Full Text)
McGahan JP, Richarks JR. Blunt abdominal trauma : the role of emergent sonography and a review of the literature. AJR Am J Roentgenol 1999; 172:897-930. (Medline).
Bode PJ, Edwards MJR, Kruit MC, van Vugt AB, Sonography in a clinical alogorithm for early evaluation of 1671 patients with blunt abdominal trauma. AJR Am J Roentgenol 1999; 172: 905-911. (Abstract)
Sirlin CB, Casola G, Bendavid EJ, Brown MA, Patel N, Hoyt DB. Significance of abdominal free fluid with screening ultrasound in female trauma patients of reproductive age (abstr). Radiology 1998; 209(P): 496.
Richards JR, McGahan JP, Simpson JL, Tabar P. Bowel and mesenteric injury: evaluation with emergency abdominal US. Radiology 1999; 211:399-403. (Abstract/Free Full Text)
Perry MJ, Porte ME, Urwin GH. Limitation of ultrasound evaluation in acute closed renal trauma. J R Coll Surg Edinb 1997; 42:420- 422. (Medline)
McGahan JP, Richards JR, Jones CD, Gerscovich EO. The use of ultrasound in acute renal trauma (abstr). Radiology 1998; 209 (P): 496.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 The ASEAN Journal of Radiology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Disclosure Forms and Copyright Agreements
All authors listed on the manuscript must complete both the electronic copyright agreement. (in the case of acceptance)
