Hypotensive Patients with Blunt Abdominal Trauma: Performance of Screening US

Farahmand, Navid; Sirlin, Claude B.; Brown, Michèle A.; Shragg, G.Paul; Fortlage, Dale; Hoyt, David B.; Casola, Giovanna

doi:10.1148/radiol.2352040583

Cited by 87 publications

(47 citation statements)

References 30 publications

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“…This facility was not available at the facilities during the period of study. We had to rely on ultrasonography (which is operator dependent) and clinical judgment to determine those patients that would require emergent surgical intervention 28 . Retrospectively we have found that sound clinical judgment with at least an abdomino-pelvic ultrasonography (in suspected gut perforation or abdominal trauma) and/or plain abdominal x-ray (in suspected intestinal obstruction) gave a diagnostic accuracy of 90.4% and negative laparotomy rate was zero percent.…”

Section: Discussionmentioning

confidence: 99%

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Etonyeaku¹,

Talabi²,

Akinkuolie³

et al. 2017

East. Cent. Afr. J. Surg.

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Background: Surgical abdomen traverses all age groups. We sought to define the aetiology, patients' characteristics, and outcome of management amongst children Methods: Two years prospective review of patients aged 5-15 years managed for surgical abdomen at the Wesley Guilds Hospital Ilesa and Mishmael Medical Centre Akure, Nigeria. Results: Fifty two patients were treated. The male: female ratio was 1:1. The age range was 5years to 15years (mean=11.25 ±2.24years). Mean duration of illness was 29.5hours (range 2-72hours). Gut perforation was the most common aetiology (n=39; 75%); with perforations due to infections most prevalent (n= 34; 87.2%). Ten cases (19.2%) were trauma related and showed male predominance. Obstructed gut accounted for 15.4% (n=8) of cases; and showed female predominance. Five out of the eight small bowel obstructions (62.5%) were due to post operation adhesions. Pre-operative and post-operative diagnoses were congruent in 90.4% (n=47) of cases. Major post-operative complications were surgical site infection (20; 38.5%), and pneumonia (5; 9.6%). The average hospital stay was 9days (range 4-21days). Mortality rate was 1.9% (n=1). Conclusion: Acute abdomen requiring surgical intervention is mainly infective origin. The male child is more at risk of abdominal trauma while gut obstruction was more common in females.

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Section: Discussionmentioning

confidence: 99%

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Etonyeaku¹,

Talabi²,

Akinkuolie³

et al. 2017

East. Cent. Afr. J. Surg.

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“…Abdominal injuries are the third common cause of traumatic death after head and chest injuries [11]. Diagnostic peritoneal lavage (DPL) has been done Patients, Correlation with Computed Tomography historically to detect hemoperitoneum.…”

Section: Discussionmentioning

confidence: 99%

Focused Sonography in Detecting Hemoperitoneum in Blunt Abdominal Trauma Patients, Correlation with Computed Tomography

Qamari¹,

Sayani²,

Ali³

et al. 2013

IJMI

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Abstract:To determine the accuracy of focused assessment with sonography for trauma in detecting the hemoperitoneum in blunt abdominal trauma patients and comparing it with Computed Tomographic findings. The study was conducted at Radiology department of Dr. Ziauddin University Hospital from March 2010 to September 2010. 140 patients presented with complaints of acute blunt abdominal trauma. Focused assessment with sonography for trauma was performed. Presence of intra-abdominal fluid was taken as positive finding for hemoperitoneum. Then all the patients underwent computed tomography of abdomino-pelvic region. Focused assessment with sonography for trauma findings were compared with computed tomography results. In 83 patients, the FAST showed free intra abdominal fluid and was taken as 'positive'. Out of these 83 cases80 (96%) were 'true positive' while the remaining 3(4%) were 'false positive' when compared with results of CT scan.Similarly, in 57 patients, no free intra abdominal fluid was detected on FAST and they were considered 'negative'. From these 57 patients, 50 (88%) patients were 'true negative' and 7 (12%) were 'false negative' because intra abdominal free fluid was seen in them on subsequent CT scan. Thus the sensitivity and specificity of FAST in detecting intra abdominal free fluid was calculated to be 91.9 % and 94.34 % respectively. FAST scan is moderately sensitive in detecting intra abdominal free fluid when compared with the results of CT scan.

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“…Clinically, the FAST scan is particularly beneficial in the hypotensive trauma patient whose source of hypotension is unclear. 17 Despite the encouraging literature, it is important to remember that all ultrasound, including the FAST exam, is dependent on the training and experience of the clinician. A study evaluating non-radiologist physicians (surgeons and emergency medicine physicians) found that while the initial error rate for FAST scans was 17%, it fell to 5% after performing ten exams.…”

Section: Ultrasound In Blunt Trauma Abdomenmentioning

confidence: 99%

Applications of ultrasound in the low and middle income countries

Vohra

Jasuja

2016

Int J Res Med Sci

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Hypotensive Patients with Blunt Abdominal Trauma: Performance of Screening US

Abstract: In patients who are hypotensive after blunt abdominal trauma and not hemodynamically stable enough to undergo diagnostic CT, negative US findings virtually exclude surgical injury, while positive US findings indicate surgical injury in 64% of cases.

Cited by 87 publications

References 30 publications

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Focused Sonography in Detecting Hemoperitoneum in Blunt Abdominal Trauma Patients, Correlation with Computed Tomography

Applications of ultrasound in the low and middle income countries

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