Screening US for blunt abdominal trauma: a retrospective study.
OBJECTIVE
To assess the accuracy of screening US in patients with blunt abdominal trauma first admitted in the trauma centre of our general hospital.


METHODS
The reports of 864 abdominal US examinations of primary trauma patients (139 with major and 725 with minor injuries) obtained with standard protocols were retrieved. For each case, US reports were reviewed and compared to the best available reference standard. The accuracy of US was assessed by evaluating the method's overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict injuries separately and independently.


RESULTS
US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensibility and 97.5% specificity in major trauma patients vs. 73.3% sensibility and 98.1% specificity in minor trauma patients) and a satisfactory specific ability to depict injuries separately and independently in major trauma patients. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor trauma), only one affected patient management, a major trauma case, by delaying an emergency laparotomy.


CONCLUSIONS
Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to screening CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US has the not secondary task of performing a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation.
Salera
Diego
D
Istituto di Radiologia, Università Politecnica delle Marche, Facoltà di Medicina, Ospedale Umberto I, Ancona.
Argalia
Giulio
G
Giuseppetti
Gian Marco
GM
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*