Abdominal Ultrasound as a Reliable Indicator for Conclusive Laparotomy in Blunt Abdominal Trauma

Bode, P. J.; Niezen, R A; Vugt, A.B. van; Schipper, J. Clasien de

doi:10.1097/00005373-199301000-00005

Cited by 145 publications

(44 citation statements)

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“…This same group also was first to comment on the effect of training and experience and reported that surgeons with extensive ultrasound experience could diagnose intra-abdominal fluid with a sensitivity of 96% and an accuracy of 99%. Interest and experience with ultrasound for trauma grew steadily around the world among surgeons and emergency physicians during the early 1990s [4][5][6][7]. During this period, ultrasound technology was improving with regard to price, portability, and resolution, allowing its use during resuscitation.…”

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confidence: 99%

Ultrasound in abdominal trauma

Rose

2004

Emergency Medicine Clinics of North America

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Ultrasound in the evaluation of abdominal trauma has evolved over the past 30 years. The use of ultrasound for abdominal trauma was described initially by Kristensen and colleagues [1] in 1971. In 1976, Ascher and colleagues [2] first reported the accuracy of ultrasound in Radiology, with 80% sensitivity for the detection of splenic injury. In a study of 808 patients, Tiling and colleagues [3] in 1990 reported a sensitivity of 89%, a specificity of 100%, and an accuracy of 98%. This same group also was first to comment on the effect of training and experience and reported that surgeons with extensive ultrasound experience could diagnose intra-abdominal fluid with a sensitivity of 96% and an accuracy of 99%. Interest and experience with ultrasound for trauma grew steadily around the world among surgeons and emergency physicians during the early 1990s [4][5][6][7]. During this period, ultrasound technology was improving with regard to price, portability, and resolution, allowing its use during resuscitation. At the same time, in the United States, there was continuing reliance on diagnostic peritoneal lavage (DPL) and CT and much less interest in sonography for abdominal trauma. This all changed when emergency physicians and surgeons in the United States began to publish their experience with ultrasound [4,8,9]. The term Focused Assessment with Sonography for Trauma (FAST) was coined by Rozycki et al [10] in 1996 and has persisted as the accepted acronym for the trauma ultrasound evaluation. The basic four-view examination (perihepatic, perisplenic, pelvic, and pericardial views) has become the foundation of the FAST examination. The rapid, noninvasive, and practical nature of ultrasound for bedside evaluation of critically injured patients has changed the evaluation of blunt abdominal trauma.

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confidence: 99%

Ultrasound in abdominal trauma

Rose

2004

Emergency Medicine Clinics of North America

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“…1 In analyzing studies, sensitivity of ultrasonography for detection of free fluid was found to correlate with organ injury in the range of 80 to 90%. [4][5][6][7] In Luks and coworkers' study, 35% of abdominal injuries in blunt pediatric trauma were renal injuries. 10 In most other series of ultrasonographic evaluation of blunt abdominal trauma, renal injuries are rare.…”

Section: Discussionmentioning

confidence: 99%

“…The first reason may be due to the fact that many studies lacked a correlation with CT or laparotomy in all patients. 4,6,7 These studies often included correlation with an improved physical examination as their criterion for a true negative ultrasonographic examination. We know that most renal injuries improve with conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

Use of ultrasonography in the patient with acute renal trauma.

McGahan

Richards

Jones

et al. 1999

Journal of Ultrasound in Medicine

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The purpose of this study was to assess the use of emergent ultrasonographic examination in acute traumatic renal injuries. Over a 3 year period, prospective data of all patients who had an emergency ultrasonogram were recorded. Thirty‐two patients with 37 renal injuries were studied retrospectively to identify in how many patients the sonogram detected free fluid or a renal parenchymal abnormality. Free fluid in the abdomen was identified in 19 of 32 patients (59%). However, 12 of these 19 patients had concomitant injury, such as splenic rupture requiring splenectomy, severe liver lacerations, or bowel lacerations requiring repair, that were possible causes of the free fluid. Eliminating these patients, only seven of 20 patients with isolated renal injuries had free fluid in the abdomen (35%), whereas 13 of 20 patients (65%) had no evidence of free fluid. All seven patients with free fluid had moderate or severe renal injuries. Renal parenchymal abnormalities were identified on ultrasonograms in eight of 37 (22%) of injured kidneys. The abnormalities were detected more commonly in cases of severe injury (60%). In conclusion, acute injuries of the kidney from blunt abdominal trauma often are associated with significant splenic, hepatic, or bowel trauma. Isolated renal injuries frequently occur without the presence of free fluid in the abdomen. Furthermore, the ultrasonogram of the kidney often is normal with acute renal injuries, but it is more likely to be abnormal with severe (grade II or greater) renal injuries. Sonography may be used in the triage of patients with blunt abdominal trauma and possible renal injury. However, a negative ultrasonogram does not exclude renal injury, and, depending on clinical and laboratory findings, other imaging procedures such as computed tomography should be performed.

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“…1 It is well known that ultrasound is not accurate in early assessment of solid organ injury 2 ; however the early recognition of free intraperitoneal fluid in these patients is helpful in expediting further management decisions. In previously published studies the sensitivity of FAST ranges from 75% to 100% and specificity from 88% to 100% [3][4][5][6][7][8][9][10][11] . In practice FAST is readily repeatable and if there is suspicion of intra-abdominal injury a repeat scan is advised.…”

Section: Discussionmentioning

confidence: 99%

To evaluate the introduction of a focussed assessment with sonography in trauma (FAST) scan into the early assessment of trauma patients

Patil¹

2016

ijsrm

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Objectives: To evaluate the introduction of a focussed assessment with sonography in trauma (FAST) scan into the early assessment of trauma patients. Methods:The setting was multispeciality hospital and critical care centre. All patients aged 16 or over admitted with blunt trauma requiring fluid resuscitation for hypovolemic shock in a prospective observational study. Patients had a FAST scan performed at the end of the primary survey. Results were compared to results of other investigations, laprotomy, and postmortem examination.Results: 50 patients were entered into the study. The sensitivity of FAST scan was 66.66% and specificity was 95%. Conclusion:FAST is highly specific "rule in" technique and is useful in the initial assessment of trauma patients. Emergency physicians can perform FAST after a brief training period.

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Abdominal Ultrasound as a Reliable Indicator for Conclusive Laparotomy in Blunt Abdominal Trauma

Cited by 145 publications

References 0 publications

Ultrasound in abdominal trauma

Ultrasound in abdominal trauma

Use of ultrasonography in the patient with acute renal trauma.

To evaluate the introduction of a focussed assessment with sonography in trauma (FAST) scan into the early assessment of trauma patients

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