Sonographic assessment of blunt abdominal trauma: A 4-year prospective study

John R Richards, Nicole H. Schleper, Brian D. Woo, Paul A. Bohnen, John P McGahan

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Purpose. Emergency abdominal sonography has become a common modality worldwide in the evaluation of injuries caused by blunt trauma. The sensitivity of sonography in the detection of hemoperitoneum varies, and little is known about the accuracy of sonography in the detection of injuries to specific organs. The purpose of this study was to determine the overall accuracy of sonography in the detection of hemoperitoneum and solid-organ injury caused by blunt trauma. Methods. From January 1995 to October 1998, 3,264 patients underwent emergency sonography at our institution to evaluate for free fluid and parenchymal abnormalities of specific organs caused by blunt trauma. All patients with intra-abdominal injuries (IAIs) were identified, and their sonographic findings were compared with their CT and operative findings, as well as their clinical outcomes. Results. Three hundred ninety-six (12%) of the 3,264 patients had IAIs. Sonography detected free fluid presumed to represent hemoperitoneum in 288 patients (9%). The sonographic detection of free fluid alone had a 60% sensitivity, 98% specificity, 82% positive predictive value, and 95% negative predictive value for diagnosing IAI. The accuracy was 94%. Seventy patients (2%) had parenchymal abnormalities identified with sonography that corresponded to actual organ injuries. The sensitivity of the sonographic detection of free fluid and/or parenchymal abnormalities in diagnosing IAI was 67%. Conclusions. Emergency sonography to evaluate patients for injury caused by blunt trauma is highly accurate and specific. The sonographic detection of free fluid is only moderately sensitive for diagnosing IAI, but the combination of free fluid and/or a parenchymal abnormality is more sensitive.

Original languageEnglish (US)
Pages (from-to)59-67
Number of pages9
JournalJournal of Clinical Ultrasound
Volume30
Issue number2
DOIs
StatePublished - 2002

Fingerprint

Ultrasonography
Abdominal Injuries
Prospective Studies
Wounds and Injuries
Hemoperitoneum
Nonpenetrating Wounds
abnormalities
organs
fluids
emergencies
Emergencies
sensitivity
Sensitivity and Specificity
evaluation

Keywords

  • Blunt abdominal trauma injury
  • Ultrasonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

Cite this

Sonographic assessment of blunt abdominal trauma : A 4-year prospective study. / Richards, John R; Schleper, Nicole H.; Woo, Brian D.; Bohnen, Paul A.; McGahan, John P.

In: Journal of Clinical Ultrasound, Vol. 30, No. 2, 2002, p. 59-67.

Research output: Contribution to journalArticle

Richards, John R ; Schleper, Nicole H. ; Woo, Brian D. ; Bohnen, Paul A. ; McGahan, John P. / Sonographic assessment of blunt abdominal trauma : A 4-year prospective study. In: Journal of Clinical Ultrasound. 2002 ; Vol. 30, No. 2. pp. 59-67.
@article{38b77187608e4681ac07bbee566e332a,
title = "Sonographic assessment of blunt abdominal trauma: A 4-year prospective study",
abstract = "Purpose. Emergency abdominal sonography has become a common modality worldwide in the evaluation of injuries caused by blunt trauma. The sensitivity of sonography in the detection of hemoperitoneum varies, and little is known about the accuracy of sonography in the detection of injuries to specific organs. The purpose of this study was to determine the overall accuracy of sonography in the detection of hemoperitoneum and solid-organ injury caused by blunt trauma. Methods. From January 1995 to October 1998, 3,264 patients underwent emergency sonography at our institution to evaluate for free fluid and parenchymal abnormalities of specific organs caused by blunt trauma. All patients with intra-abdominal injuries (IAIs) were identified, and their sonographic findings were compared with their CT and operative findings, as well as their clinical outcomes. Results. Three hundred ninety-six (12{\%}) of the 3,264 patients had IAIs. Sonography detected free fluid presumed to represent hemoperitoneum in 288 patients (9{\%}). The sonographic detection of free fluid alone had a 60{\%} sensitivity, 98{\%} specificity, 82{\%} positive predictive value, and 95{\%} negative predictive value for diagnosing IAI. The accuracy was 94{\%}. Seventy patients (2{\%}) had parenchymal abnormalities identified with sonography that corresponded to actual organ injuries. The sensitivity of the sonographic detection of free fluid and/or parenchymal abnormalities in diagnosing IAI was 67{\%}. Conclusions. Emergency sonography to evaluate patients for injury caused by blunt trauma is highly accurate and specific. The sonographic detection of free fluid is only moderately sensitive for diagnosing IAI, but the combination of free fluid and/or a parenchymal abnormality is more sensitive.",
keywords = "Blunt abdominal trauma injury, Ultrasonography",
author = "Richards, {John R} and Schleper, {Nicole H.} and Woo, {Brian D.} and Bohnen, {Paul A.} and McGahan, {John P}",
year = "2002",
doi = "10.1002/jcu.10033",
language = "English (US)",
volume = "30",
pages = "59--67",
journal = "Journal of Clinical Ultrasound",
issn = "0091-2751",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Sonographic assessment of blunt abdominal trauma

T2 - A 4-year prospective study

AU - Richards, John R

AU - Schleper, Nicole H.

AU - Woo, Brian D.

AU - Bohnen, Paul A.

AU - McGahan, John P

PY - 2002

Y1 - 2002

N2 - Purpose. Emergency abdominal sonography has become a common modality worldwide in the evaluation of injuries caused by blunt trauma. The sensitivity of sonography in the detection of hemoperitoneum varies, and little is known about the accuracy of sonography in the detection of injuries to specific organs. The purpose of this study was to determine the overall accuracy of sonography in the detection of hemoperitoneum and solid-organ injury caused by blunt trauma. Methods. From January 1995 to October 1998, 3,264 patients underwent emergency sonography at our institution to evaluate for free fluid and parenchymal abnormalities of specific organs caused by blunt trauma. All patients with intra-abdominal injuries (IAIs) were identified, and their sonographic findings were compared with their CT and operative findings, as well as their clinical outcomes. Results. Three hundred ninety-six (12%) of the 3,264 patients had IAIs. Sonography detected free fluid presumed to represent hemoperitoneum in 288 patients (9%). The sonographic detection of free fluid alone had a 60% sensitivity, 98% specificity, 82% positive predictive value, and 95% negative predictive value for diagnosing IAI. The accuracy was 94%. Seventy patients (2%) had parenchymal abnormalities identified with sonography that corresponded to actual organ injuries. The sensitivity of the sonographic detection of free fluid and/or parenchymal abnormalities in diagnosing IAI was 67%. Conclusions. Emergency sonography to evaluate patients for injury caused by blunt trauma is highly accurate and specific. The sonographic detection of free fluid is only moderately sensitive for diagnosing IAI, but the combination of free fluid and/or a parenchymal abnormality is more sensitive.

AB - Purpose. Emergency abdominal sonography has become a common modality worldwide in the evaluation of injuries caused by blunt trauma. The sensitivity of sonography in the detection of hemoperitoneum varies, and little is known about the accuracy of sonography in the detection of injuries to specific organs. The purpose of this study was to determine the overall accuracy of sonography in the detection of hemoperitoneum and solid-organ injury caused by blunt trauma. Methods. From January 1995 to October 1998, 3,264 patients underwent emergency sonography at our institution to evaluate for free fluid and parenchymal abnormalities of specific organs caused by blunt trauma. All patients with intra-abdominal injuries (IAIs) were identified, and their sonographic findings were compared with their CT and operative findings, as well as their clinical outcomes. Results. Three hundred ninety-six (12%) of the 3,264 patients had IAIs. Sonography detected free fluid presumed to represent hemoperitoneum in 288 patients (9%). The sonographic detection of free fluid alone had a 60% sensitivity, 98% specificity, 82% positive predictive value, and 95% negative predictive value for diagnosing IAI. The accuracy was 94%. Seventy patients (2%) had parenchymal abnormalities identified with sonography that corresponded to actual organ injuries. The sensitivity of the sonographic detection of free fluid and/or parenchymal abnormalities in diagnosing IAI was 67%. Conclusions. Emergency sonography to evaluate patients for injury caused by blunt trauma is highly accurate and specific. The sonographic detection of free fluid is only moderately sensitive for diagnosing IAI, but the combination of free fluid and/or a parenchymal abnormality is more sensitive.

KW - Blunt abdominal trauma injury

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=0036158974&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036158974&partnerID=8YFLogxK

U2 - 10.1002/jcu.10033

DO - 10.1002/jcu.10033

M3 - Article

C2 - 11857510

AN - SCOPUS:0036158974

VL - 30

SP - 59

EP - 67

JO - Journal of Clinical Ultrasound

JF - Journal of Clinical Ultrasound

SN - 0091-2751

IS - 2

ER -