Ultrasound of the traumatized spleen: Left butterfly sign in lesions masked by echogenic blood clots

Weill, Francis S.; Rohmer, P; Didier, Dominique; Coche, G

doi:10.1007/bf01889050

Cited by 7 publications

(1 citation statement)

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“…Real-time ultrasonography (5 MHz; Aloka, Tokyo, Japan) was performed within 120 min after patient's arrival to the emergency department. Patterns of splenic lesions, such as haemoperitoneum, heterogeneous parenchymal zones in the spleen, echogenic, sonotransparent and subcapsular hematomas [16,17], were recorded to confirm splenic injury. In addition to routine organ views, the US examination consisted of the evaluation of left subphrenic space around the spleen, Morison's pouch (the peritoneal fold bounded by the liver, right kidney and transverse mesocolon) and the pelvis for evidence of free intraperitoneal fluid [1,5,6,18].…”

Section: Methodsmentioning

confidence: 99%

Sensitivity of transabdominal ultrasonography in detection of intraperitoneal fluid in humans

1999

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The sensitivity and specificity of ultrasonography in detection of free intraperitoneal fluid is over 90 %. The lowest detectable volume of free fluid in humans is unknown. The distribution of intraperitoneal fluid was studied in 86 patients by transabdominal US in group A (n = 21, 10 ml of fluid), in group B (n = 15, 50 ml of fluid) and group C (n = 50, splenic trauma). Ultrasound detected fluid in 15 of 21 patients in group A, and in all patients in groups B and C. In group A 10 ml of fluid was found in 71 % of cases behind the bladder, and in only 5-14 % of cases in the upper abdomen. In group B 50 ml of fluid was found in all patients in the lower pelvis, but in only 20 % in Morison's pouch and in 7 % around the spleen. In group C 200-4500 ml of fluid was detected by US in 72 % of patients in the perisplenic space, in 60 % in Morison's pouch and in 42 % in the retrovesical space. Small volumes of free intraperitoneal fluid (10-50 ml) can be detected with current US scanners, but only near the site of injury. These results support the role of US as a primary imaging modality in abdominal trauma.

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