Document Detail


The evaluation of the role of ultrasonography and ultrasound-guided aspiration as an initial screening test in blunt abdominal trauma.
MedLine Citation:
PMID:  17372454     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The role of ultrasonography (US) as an initial screening test was evaluated in 3000 consecutive cases of blunt abdominal trauma (BAT). Seventy-three were positive for free fluid collection or organ injury. US-guided aspiration was used to rule out the hollow visceral injury in those referred to nonsurgical therapy. Sixty patients underwent laparotomy. These included 53 clinically unstable patients, three stable patients with positive US-guided aspiration for bile or intestinal contents and four who deteriorated upon conservative treatment. The remaining patients with US negative for fluid had some evidence of abdominal injury or clinical examination. Ultrasonography complemented the clinical examination. Both the sensitivity and specificity of US for the detection of free fluid were 100%. The overall sensitivity was 92% in spleen injuries, 88% in liver injuries and 100% in kidney injuries, with a positive predictive value of 96%, 100% and 100% and a specificity of 97%, 100% and 100% respectively. Retrospective correlation of US with laparotomy findings regarding free fluid showed that 50-100 mL of free fluid was minimal, 100-500 mL moderate, and above 500 mL significant. Thirteen patients completed conservative treatment with an uneventful course in the hospital. Both the US findings and the clinical condition of the patient should be considered in decision-making in BAT. Unnecessary laparotomies can be avoided when the major bleeding site is not in the abdomen and such patients can be safely observed after excluding the hollow visceral injury by US-guided aspiration. US, being rapid to perform, sensitive and easily repeatable, is quite useful as an initial screening test in BAT patients.
Authors:
H D El Abdullah; M A Dar; A K Shukla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of Saudi medicine     Volume:  16     ISSN:  0256-4947     ISO Abbreviation:  Ann Saudi Med     Publication Date:  1996 May 
Date Detail:
Created Date:  2007-03-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507355     Medline TA:  Ann Saudi Med     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  300-3     Citation Subset:  -    
Affiliation:
Departments of Surgery and Radiology, King Khalid General Hospital, Hafar Al Batin, Saudi Arabia.
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