Role of ultrasonography in blunt abdominal trauma.
Patients with blunt abdominal trauma (BAT) often have equivocal signs of intra-abdominal injury. Diagnostic peritoneal lavage (DPL) has been the 'gold standard' for evaluating these patients, the use of ultrasound (US) being a recent phenomenon. Seventy-three patients with BAT and equivocal physical signs were subjected to both DPL and US for detection of intra-abdominal injury. Based on clinical status, DPL and US findings, the patients underwent laparotomy or non-operative management. DPL was positive in 35 patients. There was one false positive and one false negative result (sensitivity 97.1%, specificity 97.4%, accuracy 97.3%). US was positive in 31 patients. There were 5 false positive and 4 false negative results (sensitivity 86.7%, specificity 88.4%, accuracy 87.7%). Solid viscus injury was documented at laparotomy in 24 patients. DPL failed to detect one pancreatic injury, while US failed to detect 4 splenic and 2 liver injuries. US additionally detected a single case of haemopericardium. Although DPL outperformed US in this study, US can complement DPL in defining the organs injured and in follow up of patients undergoing non-operative management for BAT.
Singh
G
G
Department of Surgery, PostGraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Arya
N
N
Safaya
R
R
Bose
S M
SM
Das
K M
KM
Khanna
S K
SK
D000007:Abdominal Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis / Q000000981:diagnostic imaging; D006491:Hemothorax / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging*