Prospective Comparison of Diagnostic Peritoneal Lavage, Computed Tomographic Scanning, and Ultrasonography for the Diagnosis of Blunt Abdominal Trauma

Liu, Ming; Lee, Chen‐Hsen; P’eng, Fang-Ku

doi:10.1097/00005373-199308000-00016

Cited by 237 publications

(111 citation statements)

References 0 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…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.…”

mentioning

confidence: 99%

Ultrasound in abdominal trauma

Rose

2004

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

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.

show abstract

mentioning

confidence: 99%

Ultrasound in abdominal trauma

Rose

2004

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

show abstract

“…[5] In addition, CT has proven to be less useful in detecting hollow viscus injuries. [6,7] Even with the introduction of helical CT, the diagnostic accuracy of CT is still debated. [8,9] Many studies have emphasized the importance of physical examinations to offset the shortcomings of CT. [10,11] Nevertheless, the findings upon physical examination are often prejudiced by the presence of torso contusions or bony fractures and by reduced consciousness because of drugs and brain injuries.…”

Section: Discussionmentioning

confidence: 99%

Will computed tomography (CT) miss something? The characteristics and pitfalls of torso CT in evaluating patients with blunt solid organ trauma

Kuo¹,

Lin²,

Foo³

et al. 2011

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

AMAÇSelektif non-operatif tedavi, künt solid organ travmalı hastalar ile ilgili standart tedavi haline gelmiştir ve bilgisayarlı vücut tomografisi (BT) yararlı terapötik ipuçları sağlamak-tadır. Biz, bu çalışmayı künt solid organ travmalı hastalarda atlanan tanıların sıklığını ve karakterini belirlemek üze-re yürüttük. BULGULARHastalar, atlanmış bir tanı bulunup bulunmamasına göre atlanan grup (24 hasta) ve değişmeyen grup (262 hasta) şek-linde gruplara ayrıldı. Genel atlanan tanı oranı %8,4 idi. Yalnızca tanımlanmamış bir bağırsak yaralanması takip BT'si ile açığa çıkarıldı, atlanan yaralanmaların hepsi laparotomi ile ortaya çıkarıldı. Atlanan grup, daha yüksek bir Yaralanma Şiddet Skoru, daha düşük Glasgow Koma Skalası, daha fazla Yoğun Bakım Ünitesi (YBÜ) tedavisi ve daha uzun hastanede kalma süresine sahip olmuştur. SONUÇCiddi travması uzun süre devam eden hastalarda, atlanmış tanıların ortaya çıkarılması seyrektir. Laparotomi atlanmış tanı-ların hepsini ortaya çıkarmış ve takip BT'si tanımlanmamış yaralanmaların saptanmasında düşük bir yeteneğe sahip olduğunu ortaya koymuştur. Klinik kötüleşme oluşması durumunda, künt solid organ travmalı hastaların non-operatif tedavisinde takip BT'si yerine laparotomi yapılmasını öneriyoruz.Anahtar Sözcükler: Künt abdominal travma; bilgisayarlı tomografi; laparotomi; atlanan yaralanma; solid organ yaralanması.

show abstract

“…11 Abdominal CT effectively identifies free blood and solid organ injuries; however, it is less effective in diagnosing diaphragmatic, pancreatic, and hollow viscus injuries. 14,16 Despite its many advantages, abdominal CT is a relatively costly and time-consuming diagnostic tool that is contraindicated in unstable and critically ill patients.…”

mentioning

confidence: 99%

“…FAST can accurately identify hemoperitoneum; however, it is not as accurate as CT in identifying solid organ injuries. 16,17 Although sonography has the advantage of being non-invasive, its superior or equivalent sensitivity in comparison to DPL has not been consistently demonstrated.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Peritoneal Lavage – A Lost Art? A Retrospective Observational Study at a Canadian Tertiary Trauma Centre

Quinzio¹,

Petrie²,

Tallon³

2009

DMJ

View full text Add to dashboard Cite

INTRODUCTION: Abdominal trauma is a leading cause of morbidity and mortality in the young, adult patient in North America. The standard tools to assess the severity of abdominal trauma have been evolving. The continuing role of diagnostic peritoneal lavage (DPL) as a clinical tool to evaluate intra-abdominal injury today remains controversial. This study investigated trends in the use of DPL, CT (computerized tomography) and FAST (Focused Assessment with Sonography for Trauma) in trauma patients in the province of Nova Scotia's single adult tertiary trauma centre.

show abstract

Prospective Comparison of Diagnostic Peritoneal Lavage, Computed Tomographic Scanning, and Ultrasonography for the Diagnosis of Blunt Abdominal Trauma

Cited by 237 publications

References 0 publications

Ultrasound in abdominal trauma

Ultrasound in abdominal trauma

Will computed tomography (CT) miss something? The characteristics and pitfalls of torso CT in evaluating patients with blunt solid organ trauma

Diagnostic Peritoneal Lavage – A Lost Art? A Retrospective Observational Study at a Canadian Tertiary Trauma Centre

Contact Info

Product

Resources

About