Usefulness and limitations of ultrasonography in the initial evaluation of blunt abdominal trauma.
BACKGROUND
In the assessment of blunt abdominal trauma, the reliability of ultrasonography (US) in identifying individual organ injuries remains uncertain, in spite of its usefulness in detecting hemoperitoneum. This study was designed to evaluate the overall diagnostic value of US, including identification of individual organ injuries.


METHODS
The accuracy of US in the detection of intra-abdominal injuries and the identification of individual organ injuries was evaluated in 1,239 patients seen during a 15-year period. Accuracy was based on detection of intraperitoneal fluid, free air, or irregular parenchymal lesions.


RESULTS
For the detection of injuries, US was 94.6% sensitive, 95.1% specific, and 94.9% accurate. Individual organ injuries were identified with sensitivities of 92.4, 90.0, 92.2, 71.4, and 34.7% for the liver, spleen, kidneys, pancreas, and intestine, respectively.


CONCLUSIONS
US is reliable for the detection of injuries and the identification of solid-organ injuries despite its poor sensitivity for intestinal injuries.
Department of Surgery, Saiseikai Kanagawaken Hospital, Yokohama, Japan.
H
H
Yoshii
M
M
Sato
S
S
Yamamoto
M
M
Motegi
S
S
Okusawa
M
M
Kitano
A
A
Nagashima
M
M
Doi
K
K
Takuma
K
K
Kato
N
N
Aikawa
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*