THE ROLE OF ULTRASONOGRAPHY IN BLUNT ABDOMINAL-TRAUMA - A PROSPECTIVE-STUDY

The evaluation of blunt abdominal trauma (BAT) can be difficult becaus e of the subtle manifestations of the injuries and because assessment is hampered by altered neurologic status. Short of laparotomy, CT and diagnostic peritoneal lavage provided the best means of accurately dia gnosing intra-abdominal injury. Ultrasound (US) has recently been intr oduced into trauma centers in the United States as a quick, cheap, and safe method to make the diagnosis of BAT. After theoretical and pract ical training, one attending surgeon and one chief resident began perf orming trauma ultrasounds at a rural, Level 1 trauma center. The US wa s performed concurrent with initial resuscitation and prior to other s tudies. The US was then correlated with the other tests. Of the 82 tes ts performed, 79 correlated with other methods of diagnosis. Overall, US was 88 per cent sensitive, 98 per cent specific, and 96 per cent ac curate in diagnosing intra-abdominal injuries. There were no operative sequelae to patients whose injury was missed by US. We conclude that: 1) US can be used as the initial method of diagnosis of BAT and 2) su rgeons are able to perform the examination accurately.