Fm. Akgur et al., INITIAL EVALUATION OF CHILDREN SUSTAINING BLUNT ABDOMINAL-TRAUMA - ULTRASONOGRAPHY VS DIAGNOSTIC PERITONEAL-LAVAGE, European journal of pediatric surgery, 3(5), 1993, pp. 278-280
A prospective clinical study was performed to compare ultrasonography
(US) with a modality having 96-99 % accuracy like diagnostic peritonea
l lavage (DPL) to find the accuracy of US in the initial evaluation of
children sustaining blunt abdominal trauma (BAT). Sixty-eight childre
n with BAT were initially evaluated by US, then DPL. All patients with
pathologic US findings underwent computerized tomographic examination
before DPL to confirm the pathologies. Through US examination free in
traperitoneal fluid (FIF) was present in eleven, absent in 57 patients
. DPL was positive in ten, negative in 58 patients. Sensitivity, speci
ficity, negative predictive value, positive predictive value and effic
iency of US were 100, 98.3, 100, 91 and 98.5 respectively. US detected
intraperitoneal solid organ injuries in eleven patients, but DPL was
positive in only ten of these patients. While US detected renal injuri
es in six patients and intrapleural fluid in two patients, DPL was pos
itive in only two of these patients as a result of concomitant intrape
ritoneal solid organ injuries with FIF. The present study has shown th
at US can detect FIF with a high rate of accuracy comparable to DPL in
children. In addition, US has advantages over DPL in the detection of
intraperitoneal organ injuries with or without concomitant FIF, retro
peritoneal injuries and intrathoracic injuries. Thus US is thought to
be superior to DPL and recommended as a routine first choice screening
tool in the initial evaluation of children sustaining BAT.