Use of Ultrasound to Determine Need for Laparotomy in Trauma Patients

Porter, Robert S.; Nester, Brian A; Dalcey, William C; O'Mara, Michelle; Gleeson, Tara; Pennell, Rebecca G.; Beyer, Frederick C.

doi:10.1016/s0196-0644(97)70343-3

Cited by 74 publications

(34 citation statements)

References 12 publications

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“…Porter et al reviewed 1631 trauma patients who underwent ultrasound as the primary screening test for abdominal injury to evaluate its role in determining the need for laparotomy (32). Of the 86 patients who required laparotomy, the FAST examination was positive in 80 (sensitivity of 93%, specificity 90%) (32).…”

Section: Discussionmentioning

confidence: 99%

“…We did not study the use of serial FAST examinations; repeat examinations may further increase the sensitivity of FAST for predicting the need for laparotomy, as several studies have suggested (1,2,12,15,27,28,32). When mandated by the mechanism of injury or an evolving physical examination, serial FAST examinations or an abdominal CT scan should be performed on the patient.…”

Section: Limitationsmentioning

confidence: 99%

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Association Between a Positive ED FAST Examination and Therapeutic Laparotomy in Normotensive Blunt Trauma Patients

Moylan

Newgard

John

et al. 2007

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Association Between a Positive ED FAST Examination and Therapeutic Laparotomy in Normotensive Blunt Trauma Patients

Moylan

Newgard

John

et al. 2007

The Journal of Emergency Medicine

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“…While there are limitations to the study, such as subcutaneous emphysema, obesity and abdominal scars, its sensitivity ranges from 82% to 99% and the specificity is from 95% to 99.7%. 3,4 In addition, the use of contrast enhanced ultrasound has been shown to be valuable in the characterization of paediatric patients with solid organ injuries. 5 The additional benefit of contrastenhanced ultrasound is that it is not nephrotoxic.…”

Section: Traumamentioning

confidence: 99%

Ultrasound: the triage tool in the emergency department: using ultrasound first

Nicola

Dogra

2016

BJR

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Ultrasound in the emergency department has long been recognized as a powerful screening and diagnostic tool for both physicians and radiologists. In the emergency department, since time is of the essence, it becomes a critical tool in triaging patients. Over the years, ultrasound has gained several advantages over other modalities because of its nonionizing radiation, portability, accessibility, non-invasive method and simpler learning curve. As a result, ultrasound has become one of the most frequently used diagnostic tools in the emergency department by non-radiologists. The value of ultrasound is implemented in every acute ailment in the emergency department such as trauma, acute abdomen, acute pelvic pain, acute scrotal pain, appendicitis in children and acute deep venous thrombosis. Our objective is to discuss the benefit of using ultrasound as the primary modality for each of these diseases. INTRODUCTIONSince the inception of portable ultrasound machine, physicians have attempted to integrate the use of ultrasound with the physical examination. Furthermore, the technological development of various probes and transducers has paved the way for a more accurate and specific physical examination. As a result, the use of ultrasound has been integrated into the education and training of multiple specialities, such as emergency medicine, obstetrics/ gynaecology and cardiology.

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“…Ada beberapa alat bantu diagnosis yang telah digunakan untuk menunjang penegakan diagnosis cedera organ intra abdomen yaitu lavase peritoneal diagnosis, ultrasonografi (USG), CT Scan dan laparoskopi (3,4,5). Lavase peritoneal diagnosis (LPD) suatu metode untuk menunjang menegakkan diagnosis dari cedera intra abdomen telah digunakan secara luas karena dianggap cukup obyektif dalam menilai adanya cedera intra abdomen.…”

Section: Pendahuluanunclassified

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Soemarko

2013

JKB

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The diagnosis of intraperitoneal hemorrhage must be quickly with a high accuracy, before an acute exploratory laparotomy. This study was conducted to find out if intravesical pressure measurement should be as an alternative indicator of diagnostic peritoneal lavage in predicting intraperitoneal hemorrhage that indicating an acute exploratory laparotomy. Using an Explorative, Cross Sectional Design. Results of the exploratory laparotomy were used as a standard of determining the accuracy of Diagnostic Peritoneal Lavage and intravesical pressure measurement in predicting the indication for the exploratory laparotomy. 18 of 24 patients has positive results of diagnostic peritoneal lavage, but an active intraperitoneal hemorrhage only found in 15 patients, with a positive predictive value 83,33 %, negative predictive value 100%. The results of intravesical pressure measurement in the same patients predicted 17 patients has positive results, with slight a higher positive predictive value (88,24 %), negative predictive value 100%. The conclusion is the measurement of intravesical pressure is an alternative procedure of Diagnostic Peritonel lavage for predicting intraperitoneal hemorrhage.Key words: Blunt Trauma Abdomen; Intravesical Pressure Measurement; Diagnostic Peritoneal Lavage; Exploratory Laparotomy; Intraperitoneal Hemorrhage. PENDAHULUANPada cedera fisik yang memerlukan tindakan pembedahan akut didapatkan bahwa 10% diantaranya adalah akibat dari trauma tumpul didaerah abdomen. Trauma tumpul abdomen dapat menyebabkan cedera organ intra abdomen berupa ruptura organ padat seperti hepar dan lien atau perforasi organ berongga seperti lambung dan usus.Cedera intra abdomen pada pemeriksaan awal sulit untuk dideteksi. Apalagi bila penderita datang dalam keadaan tak sadar akibat trauma didaerah kepala atau akibat intoksikasi alkohol. Berdasarkan data yang berasal dari rekam medis diketahui bahwa 20% penderita dengan hemoperitoneum menunjukkan tanda tanda klinis yang benigna pada waktu pertama kali tiba di instalasi rawat darurat (1). Oleh karena itu untuk memberikan perawatan penderita secara optimal haruslah dimulai dengan evaluai awal yang teliti dengan melakukan prosedur bedah yang efektif dan efisien dalam waktu sehingga dapat secara maksimal diupayakan penyelamatan nyawa penderita. Harus diusahakan dengan benar untuk mencegah kematian yang memang seharusnya tidak terjadi (2).Untuk menegakkan diagnosis pada cedera organ pada trauma tumpul abdomen dapat menimbulkan keragu-raguan bagi ahli bedah. Tanda tanda klinis tidak selalu patognomonis menunjukkan adanya cedera organ intra abdomen. Berbeda dengan trauma terbuka atau tembus pada abdomen, pada trauma tumpul abdomen diperlukan langkah diagnosis yang lebih kompleks mengingat berbagai bentuk cedera dapat terjadi (2). Pada keadaan klinis yang meragukan dibutuhkan alat bantu tertentu untuk menegakkan diagnosis adanya cedera organ intra abdomen, sehingga dapat ditentukan ada tidaknya indikasi untuk melakukan laparotomi.Ada beberapa alat bantu diagnosis yang tel...

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Use of Ultrasound to Determine Need for Laparotomy in Trauma Patients

Cited by 74 publications

References 12 publications

Association Between a Positive ED FAST Examination and Therapeutic Laparotomy in Normotensive Blunt Trauma Patients

Association Between a Positive ED FAST Examination and Therapeutic Laparotomy in Normotensive Blunt Trauma Patients

Ultrasound: the triage tool in the emergency department: using ultrasound first

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

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