Sonography as the primary screening technique for blunt abdominal trauma: experience with 899 patients.

McKenney, Kimberley L.; Nuñez, Diego; McKenney, Mark; Asher, John; Zelnick, K; Shipshak, D

doi:10.2214/ajr.170.4.9580140

Cited by 103 publications

(50 citation statements)

References 10 publications

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“…The trauma-related mortality is 3-15%, and 10% of the deaths are due to abdominal injuries. 8,9 Sonography has been used to evaluate abdominal trauma in Europe, Japan, and Canada for more than 20 years but has become popular in the United States only during the past decade. 3,10,11 Although sonography is included in the physical examination and primary assessment of trauma patients in many centers in North America, disputes remain about who should perform the sonographic examination (surgeons or radiologists), which anatomic areas should be examined, and which conditions warrant substitution of sonography for diagnostic peritoneal lavage or CT. 2,12,13 Many authors believe that FAST should be used in trauma patients to determine whether free fluid is present in order to assist in planning further management.…”

Section: Discussionmentioning

confidence: 99%

“…3,10,11 Although sonography is included in the physical examination and primary assessment of trauma patients in many centers in North America, disputes remain about who should perform the sonographic examination (surgeons or radiologists), which anatomic areas should be examined, and which conditions warrant substitution of sonography for diagnostic peritoneal lavage or CT. 2,12,13 Many authors believe that FAST should be used in trauma patients to determine whether free fluid is present in order to assist in planning further management. 2,9 Other authors have advocated for FAST to play a more extensive role, including identification of parenchymal injury. 5,6,9 Since 1995, FAST examination has been included in the primary assessment of every multiple trauma patient at our center, including children of all ages.…”

Section: Discussionmentioning

confidence: 99%

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Experience with focused abdominal sonography for trauma (FAST) in 313 pediatric patients

Soudack

Epelman

Maor

et al. 2004

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Experience with focused abdominal sonography for trauma (FAST) in 313 pediatric patients

Soudack

Epelman

Maor

et al. 2004

J of Clinical Ultrasound

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“…1 Usually, abdominal organ injuries alone are responsible for 10% of total trauma caused mortality. 2 Blunt trauma abdomen (BTA) is a common surgical emergency which may present as an isolated problem or as a part of poly trauma. 3 Road traffic (automobile) accident is the most common cause of blunt trauma abdomen.…”

Section: Introductionmentioning

confidence: 99%

A retrospective clinical study on blunt trauma abdomen and its management

Rahman¹,

Das²

2018

Int Surg J

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Background: Blunt trauma abdomen is a common surgical emergency which may present as an isolated problem or as a part of poly trauma. Road traffic (automobile) accident is the most common cause of blunt trauma abdomen.Methods: After initial resuscitation and achieving hemodynamic stability, all patients were subjected to careful history and clinical examination. Depending on the clinical findings, decision for further investigations as four-quadrant aspiration, X-ray of chest and abdomen erect view and abdominal ultrasound were taken. The decision to operate or non-operative management depended on the outcome of clinical examination and results of diagnostic tests.Results: This is a clinical study of 100 patients who were admitted, treated and followed up in Gauhati Medical College and Hospital, Guwahati, Assam, India from 1st July, 2015 to 30th June, 2016. In this study, the incidence of blunt trauma abdomen was found to be 69.78% out of all abdominal trauma patients. The most common cause was found to be road traffic accidents (67%). The commonest age group was 21 to 30 years comprises about 39% of patients. The average age was 30.82 years. Spleen was the most common organ involved (44%). 53.52% of patient having solid organ injured was managed conservatively. Out of 60 operative cases, 25 (41.7%) cases were operated within 3-6 hours.Conclusions: Patients with blunt trauma abdomen should have early and accurate diagnosis and prompt, proper and prudent management to improve overall prognosis.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Technique varies widely among trauma centers. The examination may consist of a brief survey for fluid alone, or it may include assessment of organ parenchyma.…”

mentioning

confidence: 99%

Importance of evaluating organ parenchyma during screening abdominal ultrasonography after blunt trauma.

Brown

Casola

Sirlin

et al. 2001

J of Ultrasound Medicine

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Objective. To determine the benefit of screening ultrasonography for parenchymal abnormalities as well as free fluid during screening abdominal ultrasonography in patients with blunt trauma. Methods. A total of 2693 patients with blunt trauma who were triaged to a level 1 trauma center underwent screening abdominal ultrasonography in the resuscitation suite. Examinations were performed by experienced sonographers and included a screen for free intraperitoneal fluid and evaluation of the abdominal organ parenchyma and heart for traumatic injury. Screening ultrasonographic findings were reviewed and compared with findings from autopsy, laparotomy, diagnostic peritoneal lavage, computed tomography, repeated ultrasonography, cystography, and clinical outcome. Imaging studies of all patients with confirmed or suspected injuries were reviewed to identify those in whom parenchymal findings aided diagnosis. Results. One hundred seventy-two patients were found to have evidence of abdominal injury due to blunt trauma on the basis of clinical data, imaging, laparotomy, or autopsy. Forty-four of these patients had no sonographic evidence of hemoperitoneum at the time of initial ultrasonography. Screening ultrasonographic findings were positive for injury in 19 of 44 patients on the basis of parenchymal findings or small retroperitoneal collections of fluid thought to be indicative of trauma. In the remaining 25 patients, screening ultrasonography showed no abnormalities, and injuries were detected by repeated ultrasonography, subsequent computed tomography, or diagnostic peritoneal lavage performed for suspected occult injury on the basis of clinical parameters. In addition, 47 of 126 injured patients with sonographically detected free fluid had parenchymal findings that helped localize injury. Sixteen of those patients were taken to the operating room on the basis of clinical and sonographic findings without undergoing computed tomography. Conclusions. The inability to show injuries with no hemoperitoneum or with delayed hemoperitoneum has been shown to be a limitation of ultrasonography in patients with blunt trauma. In our series, 26% of all patients with documented injuries had no free fluid visible on screening ultrasonography. Attention to findings other than free fluid allowed detection in 43% of injured patients without sonographic evidence of hemoperitoneum.

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Sonography as the primary screening technique for blunt abdominal trauma: experience with 899 patients.

Cited by 103 publications

References 10 publications

Experience with focused abdominal sonography for trauma (FAST) in 313 pediatric patients

Experience with focused abdominal sonography for trauma (FAST) in 313 pediatric patients

A retrospective clinical study on blunt trauma abdomen and its management

Importance of evaluating organ parenchyma during screening abdominal ultrasonography after blunt trauma.

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