Ultrasonography in the management of blunt abdominal and thoracic trauma
K. Glaser, J. Tschmelitsch, P. Klingler, G. Wetscher and E. Bodner
Second Department of Surgery, University of Innsbruck, Austria.
OBJECTIVE: To assess the sensitivity, specificity, and predictive value of
ultrasonography in patients with blunt abdominal or thoracic trauma in
regard to the indication for immediate operation, delayed abdominal
exploration, or conservative treatment. DESIGN: A retrospective study was
conducted after consecutive sampling of 1151 patients in a nonrandomized
control trial. SETTING: The study was conducted at the University Hospital
of Innsbruck (Austria), which serves as a general community hospital and a
major primary care and referral center. PATIENTS: All patients with blunt
abdominal or thoracic trauma with or without polytraumatization were
eligible for the study; a total of 1151 patients were observed from 1980 to
1990. According to the ultrasonographic findings, patients were divided
into three groups: immediate operation, primary conservative treatment, and
conservative treatment (normal ultrasonographic findings). Ultrasonography
was repeated when the clinical findings or laboratory test results showed
the development of intra-abdominal hemorrhage or signs of organ laceration.
INTERVENTION: Ultrasonography in the emergency department or intensive care
unit. MAIN OUTCOME MEASURES: Conservative or operative treatment based on
ultrasonographic and clinical findings. RESULTS: Ultrasonography showed a
sensitivity of 99%, a specificity of 98%, a positive predictive value of
0.97, and a negative predictive value of 0.99 in regard to the indication
for surgery in cases of blunt abdominal or thoracic trauma. Ultrasonography
is not reliable in patients with intestinal perforation and large
retroperitoneal hematomas. CONCLUSION: Ultrasonography saves time and
money, can be performed in the emergency department, shows high sensitivity
and specificity, and is the method of first choice in the evaluation of
blunt trauma.
Evaluation of focussed assessment with sonography in trauma (FAST) by UK emergency physicians.
Brenchley et al.
Emerg. Med. J. 2006;23:446-448.
ABSTRACT
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Bedside Ultrasonography in the ICU: Part 2
Beaulieu and Marik
Chest 2005;128:1766-1781.
ABSTRACT
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Contrast-Enhanced Two- and Three-dimensional Sonography for Evaluation of Intra-abdominal Hemorrhage
Liu et al.
J Ultrasound Med 2002;21:161-169.
ABSTRACT
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Focused Abdominal US in Patients with Trauma
Lingawi and Buckley
Radiology 2000;217:426-429.
ABSTRACT
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Imaging in abdominal trauma
Wherry and Punzalan
Trauma 2000;2:283-290.
ABSTRACT
Echoes of things to come. Ultrasound in UK emergency medicine practice
Brenchley et al.
Emerg. Med. J. 2000;17:170-175.
ABSTRACT
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Role of US in the Diagnosis of Intraabdominal Catastrophes
McKenney
RadioGraphics 1999;19:1332-1339.
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Hemoperitoneum as the Sole Indicator of Abdominal Visceral Injuries: A Potential Limitation of Screening Abdominal US for Trauma
Shanmuganathan et al.
Radiology 1999;212:423-430.
ABSTRACT
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Current technology: laparoscopic surgery in trauma
Brooks and Boffard
Trauma 1999;1:53-60.
ABSTRACT
"Alternative" Surgery in Trauma Management
Britt and Cole
Arch Surg 1998;133:1177-1181.
ABSTRACT
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