Ultrasound in emergency patients: better detection of free intraabdominal fluids by the use of tissue harmonic imaging.
BACKGROUND
Ultrasound examination is one of the main investigative procedures in emergency patients who are hospitalized due to abdominal pain. Detectable free fluid collections are important hints to the definite, sometimes life-threatening diagnosis, but their detection in cases of only small amounts is difficult to perform by conventional sonography.


METHODS
We report about 25 cases of patients who suffered from acute abdominal pain and who were presented as emergency patients to our department of ultrasound. First, the examination was performed by conventional sonography (3.4 MHz). Only with the additional tissue harmonic imaging (THI, 2.3 MHz, pulse inversion) thin borders of free fluids around the liver or other abdominal organs (gallbladder, spleen, pancreas, bowel) could be detected leading to other important diagnostic or therapeutic steps. In this way, the diagnosis of pancreatitis, cholezystitis, peritonitis, peritoneal carcinosis, ascites (liver cirrhosis, serositis, postoperative status after laparotomy), bleeding or paralytic ileus could be elucidated.


CONCLUSIONS
THI sonography improves the detection of small amounts of free abdominal fluid collections. Therefore, this technique is helpful in the diagnostic procedure of emergency patients.
Schiemann
U
U
Medizinische Klinik, Klinikum der Universität-Innenstadt, Ludwig-Maximilians-Universität München, Ziemssenstrasse 1, D-80336 Münich, Germany. Uwe.Schiemann@med.uni-muenchen.de
Götzberger
M
M
Reissenweber
H
H
Suttmann
I
I
Berner
I
I
Hoyer
X
X
Heldwein
W
W
D034841:Abdominal Cavity / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D004630:Emergencies; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D007089:Image Enhancement; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010538:Peritonitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography
D000900:Anti-Bacterial Agents