Diagnostic value of ultrasonography in the evaluation of blunt abdominal trauma.
OBJECTIVE
To evaluate the diagnostic value of ultrasonography (US) in detecting intraabdominal injuries in patients with blunt abdominal trauma.


METHODS
Blunt trauma patients admitted to the emergency department from January 2002 to August 2003 were retrospectively evaluated. A total of 454 patients with blunt abdominal trauma who underwent US examination were included. Ultrasonography results were compared with findings of CT, diagnostic peritoneal lavage, laparotomy and clinical course. Sensitivity, specificity, positive and negative predictive values of US in detecting free fluid, intraabdominal parenchymal organ injury or both were calculated.


RESULTS
Computed tomography, diagnostic peritoneal lavage and laparotomy results showed that intraabdominal organ injury was present in 37 of 454 patients. Ultrasonography examinations were positive in 51 patients. True-positive findings were seen in 32 of these patients. In these 32 patients, US examination showed free fluid in 19, fluid and abdominal organ injury in 11 and only abdominal organ injury in 2. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US in detecting intraabdominal injury were 86.5%, 95.4%, 62.7%, 98.7% and 94.7%, respectively.


CONCLUSIONS
Ultrasonography has high diagnostic performance in the screening of patients with blunt abdominal trauma. Abdominal US is a useful and valuable diagnostic tool after clinical evaluation in patients with blunt abdominal trauma. Because of its high negative predictive value, we recommend that clinical follow up is adequate for patients whose US results are negative for intraabdomial organ injury.
Nural
Mehmet Selim
MS
Department of Radiodiagnostics, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
Yardan
Türker
T
Güven
Hakan
H
Baydin
Ahmet
A
Bayrak
Ilkay Koray
IK
Kati
Celal
C
D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology