title: Impact of Abdominal Follow-Up Sonography in Trauma Patients Without Abdominal Parenchymal Organ Lesion or Free Intraabdominal Fluid in Whole-Body Computed Tomography.
abstract: PurposePatients suffering from severe blunt abdominal trauma are challenging because of their need for accurate diagnostic imaging and fast therapeutic action. Whole-body computed tomography (WBCT) is highly sensitive and represents the gold standard in the trauma room diagnostic setting. The aim of our study was to investigate the impact and therapy relevance of abdominal follow-up sonography (AFS) as part of the tertiary trauma survey (TTS) in patients without abdominal parenchymal organ lesions or free abdominal fluid in initial WBCT.Materials and MethodsAll adult patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination, who received AFS within 24 hours after trauma, were included in this retrospective analysis between January 2008 and December 2011.Results316 patients were analyzed (ISS 10 ± 8, NISS 13 ± 11) according to the inclusion criteria. Overall, only small amounts of free intraabdominal fluid were detected in AFS in 3 patients (0.9 %) and remained without therapeutic consequence. None of the patients died due to intraabdominal bleeding.ConclusionAFS as part of the TTS did not show additional benefits and had no impact on further treatment in patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination. We conclude that AFS is not routinely required but should be performed if indicated on a clinical or laboratory basis because of its fast and less invasive character.Key points· Seriously injured patients are challenging for medical imaging and treatment.. · Whole-body computed tomography is known for its high accuracy in trauma patients.. · Nonetheless, missed injuries are a major challenge in trauma patients.. · Therefore, follow-up ultrasound is often performed within the tertiary trauma survey.. · Follow-up ultrasound in patients with an inconspicuous abdominal computed tomography scan did not show any benefit..Citation Format· Schneck E, Koch C, Borgards M et al. Impact of Abdominal Follow-Up Sonography in Trauma Patients Without Abdominal Parenchymal Organ Lesion or Free Intraabdominal Fluid in Whole-Body Computed Tomography. Fortschr Röntgenstr 2017; 189: 128 - 136.
authors.affiliation: Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Schneck
authors.affiliation: Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Koch
authors.affiliation: Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
authors.forename: Mara
authors.initials: M
authors.lastname: Borgards
authors.affiliation: Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Reichert
authors.affiliation: Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hecker
authors.affiliation: Department of Trauma Surgery, Justus-Liebig-University Giessen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Heiß
authors.affiliation: Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Padberg
authors.affiliation: Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Germany.
authors.forename: Enrique
authors.initials: E
authors.lastname: Alejandre-Lafont
authors.affiliation: Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.affiliation: Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Germany.
authors.forename: Gabriele Anja
authors.initials: GA
authors.lastname: Krombach
authors.affiliation: Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Weigand
authors.affiliation: Central Emergency Unit, University Hospital Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bernhard
authors.affiliation: Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Germany.
authors.forename: Fritz Christian
authors.initials: FC
authors.lastname: Roller
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000628:therapy; D000328:Adult; D001826:Body Fluids / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*; D014781:Viscera / Q000000981:diagnostic imaging / Q000293:injuries; D051598:Whole Body Imaging / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000628:therapy