The Role of Ultrasonography in Blunt Abdominal Trauma

Goletti, Orlando; Ghiselli, Gl; Pv, Lippolis; Chiarugi, Massimo; Braccini, G; Macaluso, Claudio; Cavina, Enrico

doi:10.1097/00005373-199402000-00004

Cited by 146 publications

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“…For instance, in a series by Goletti and colleagues, only three of 59 lesions (5%) detected in patients with blunt abdominal trauma were renal injuries. 11 However, these investigators did report that ultrasonography demonstrated free fluid in three of these cases. In the series of Rozycki and coauthors, two of 402 patients with blunt abdominal trauma had documented renal injury.…”

Section: Discussionmentioning

confidence: 93%

Use of ultrasonography in the patient with acute renal trauma.

McGahan

Richards

Jones

et al. 1999

Journal of Ultrasound in Medicine

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The purpose of this study was to assess the use of emergent ultrasonographic examination in acute traumatic renal injuries. Over a 3 year period, prospective data of all patients who had an emergency ultrasonogram were recorded. Thirty‐two patients with 37 renal injuries were studied retrospectively to identify in how many patients the sonogram detected free fluid or a renal parenchymal abnormality. Free fluid in the abdomen was identified in 19 of 32 patients (59%). However, 12 of these 19 patients had concomitant injury, such as splenic rupture requiring splenectomy, severe liver lacerations, or bowel lacerations requiring repair, that were possible causes of the free fluid. Eliminating these patients, only seven of 20 patients with isolated renal injuries had free fluid in the abdomen (35%), whereas 13 of 20 patients (65%) had no evidence of free fluid. All seven patients with free fluid had moderate or severe renal injuries. Renal parenchymal abnormalities were identified on ultrasonograms in eight of 37 (22%) of injured kidneys. The abnormalities were detected more commonly in cases of severe injury (60%). In conclusion, acute injuries of the kidney from blunt abdominal trauma often are associated with significant splenic, hepatic, or bowel trauma. Isolated renal injuries frequently occur without the presence of free fluid in the abdomen. Furthermore, the ultrasonogram of the kidney often is normal with acute renal injuries, but it is more likely to be abnormal with severe (grade II or greater) renal injuries. Sonography may be used in the triage of patients with blunt abdominal trauma and possible renal injury. However, a negative ultrasonogram does not exclude renal injury, and, depending on clinical and laboratory findings, other imaging procedures such as computed tomography should be performed.

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Section: Discussionmentioning

confidence: 93%

Use of ultrasonography in the patient with acute renal trauma.

McGahan

Richards

Jones

et al. 1999

Journal of Ultrasound in Medicine

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“…The sensitivity of US in detecting free fluid is very high and if adequately performed, the US can detect less than 50 mL of fluid, particularly in Morrison's pouch and Douglas's cul-de-sac. 6 Since the blood loss is time-dependent, the diagnostic procedure must be quick and accurate, and decision-making must be prompt and correct. In such clinical situations, US is found to be the best choice.…”

Section: Discussionmentioning

confidence: 99%

“…Although clinical instability, regardless of the amount of free fluid, forms the definite indication for laparotomy in BAT patients, there are no definite guidelines regarding the amount of hemoperitoneum indicating laparotomy in stable patients. Goletti et al have used a figure of 250 mL, 6 whereas Huang et al used the figure of 1000 mL of free fluid as the indication for laparotomy.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal Trauma

Shukla

1996

Ann Saudi Med

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The role of ultrasonography (US) as an initial screening test was evaluated in 3000 consecutive cases of blunt abdominal trauma (BAT). Seventy-three were positive for free fluid collection or organ injury. US-guided aspiration was used to rule out the hollow visceral injury in those referred to nonsurgical therapy. Sixty patients underwent laparotomy. These included 53 clinically unstable patients, three stable patients with positive US-guided aspiration for bile or intestinal contents and four who deteriorated upon conservative treatment. The remaining patients with US negative for fluid had some evidence of abdominal injury on clinical examination. Ultrasonography complemented the clinical examination. Both the sensitivity and specificity of US for the detection of free fluid were 100%. The overall sensitivity was 92% in spleen injuries, 88% in liver injuries and 100% in kidney injuries, with a positive predictive value of 96%, 100% and 100% and a specificity of 97%, 100% and 100% respectively. Retrospective correlation of US with laparotomy findings regarding free fluid showed that 50-100 mL of free fluid was minimal, 100-500 mL moderate, and above 500 ml significant. Thirteen patients completed conservative treatment with an uneventful course in the hospital. Both the US findings and the clinical condition of the patient should be considered in decision-making in BAT. Unnecessary laparotomies can be avoided when the major bleeding site is not in the abdomen and such patients can be safely observed after excluding the hollow visceral injury by US-guided aspiration. US, being rapid to perform, sensitive and easily repeatable, is quite useful as an initial screening test in BAT patients. Ann Saudi Med 1996; 16(3):300-303. Trauma. 1996; 16(3): 300-303 Blunt abdominal trauma (BAT) has always been a challenge for the treating surgeon. This situation demands quick and correct decision-making in order to both perform lifesaving procedures and to avoid unnecessary laparotomies. Clinical signs are often misleading and the routine laboratory data and conventional x-ray are often not specific. HDI El Abdullah, MA Dar, AK Shukla, The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal 1,2Peritoneal lavage has been extensively used in BAT patients. Although this gives a good idea about the nature of the fluid, it does not distinguish the organs involved and has a relatively high rate of negative laparotomies. 3,4 Computerized tomography (CT) is a good diagnostic tool as far as organ delineation is concerned, but using it in an unstable patient requires shifting of the patient from the trauma bay, with continuous resuscitation in the CT room. The new generation of helical CTs are able to scan the abdomen and thorax within a short time, but are not available in our hospital. [3][4][5] Ultrasonography (US) has emerged as a valuable diagnostic tool in BAT. It has the advantage of being mobile for bedside use and gives quick information regarding free in...

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“…Göletti ve arkadaşları taraından yapılan bir çalışmada US hakkındaki sonuçlar ise Tablo. 5'te ve rilmiştir (18). Prospektif çalışmalar US'nun sensitivitesini %74-94, retrospektif çalışmalar %84-100 olarak ra por etmiştir (19).…”

Section: Gereç Ve Yöntemunclassified

“…Prospektif çalışmalar US'nun sensitivitesini %74-94, retrospektif çalışmalar %84-100 olarak ra por etmiştir (19). US 50 ml'den az sıvıyı Morrison po şunda ve Douglas'ın cul de sac'ında saptayabilir (18).…”

Section: Gereç Ve Yöntemunclassified

Hyalen Membran Hastalığı Tanısının Adli Otopsilerdeki Önemi Olgu Sunumu

Koyutürk¹,

Özaslan²,

Koç³

et al. 1998

Bull Leg Med

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ÖZET SUMMARYIn this study; we aimed to determine whether the diag nosis and treatment protocols related to blunt abdominal trauma and splenic injury cause any changes in the view of Forensic Medicine. We evaluated the files of 58 blunt abdo minal trauma cases that are followed up by the Department of Pediatric Surgery of Medical Faculty of Uludağ University among 1988-1993.Out of 33 cases (%57) who had intraabdominal hemorr hage by the virtue of blunt abdominal trauma, splenic injury is identificated in 16 cases (%48). 12 cases (%75) with sple nic injury were treated conservatively, whereas 4 (%25) had an operation. In the treatment protocol, CT, US, peritoneal lavage, hemoglobin, hematocrite values are evaluated.The literature data concerning the blunt abdominal tra uma is reviewed, the diagnosis and treatment methods are determinated and evaluated in the view of Forensic Medici ne.

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The Role of Ultrasonography in Blunt Abdominal Trauma

Cited by 146 publications

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Use of ultrasonography in the patient with acute renal trauma.

Use of ultrasonography in the patient with acute renal trauma.

The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal Trauma

Hyalen Membran Hastalığı Tanısının Adli Otopsilerdeki Önemi Olgu Sunumu

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