2,576 Ultrasounds for blunt abdominal trauma

Matthew O. Dolich; Mark G. McKenney; J. Esteban Varela; Raymond P. Compton; Kimberly L. McKenney; Stephen M. Cohn

doi:10.1097/00005373-200101000-00019

2,576 Ultrasounds for blunt abdominal trauma

Matthew O. Dolich, Mark G. McKenney, J. Esteban Varela, Raymond P. Compton, Kimberly L. McKenney, Stephen M. Cohn

Surgery

Research output: Contribution to journal › Article › peer-review

164 Scopus citations

Abstract

Background: Determination of intra-abdominal injury following blunt abdominal trauma (BAT) continues to be a diagnostic challenge. Ultrasound (US) bas 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.

Original language	English (US)
Pages (from-to)	108-112
Number of pages	5
Journal	Journal of Trauma - Injury, Infection and Critical Care
Volume	50
Issue number	1
DOIs	https://doi.org/10.1097/00005373-200101000-00019
State	Published - Jan 1 2001

Keywords

Blunt abdominal trauma
Diagnosis
Ultrasound

ASJC Scopus subject areas

Surgery
Critical Care and Intensive Care Medicine

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title = "2,576 Ultrasounds for blunt abdominal trauma",

abstract = "Background: Determination of intra-abdominal injury following blunt abdominal trauma (BAT) continues to be a diagnostic challenge. Ultrasound (US) bas 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.",

keywords = "Blunt abdominal trauma, Diagnosis, Ultrasound",

author = "Dolich, {Matthew O.} and McKenney, {Mark G.} and Varela, {J. Esteban} and Compton, {Raymond P.} and McKenney, {Kimberly L.} and Cohn, {Stephen M.}",

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AU - Compton, Raymond P.

AU - McKenney, Kimberly L.

AU - Cohn, Stephen M.

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N2 - Background: Determination of intra-abdominal injury following blunt abdominal trauma (BAT) continues to be a diagnostic challenge. Ultrasound (US) bas 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.

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