THE ROLE OF ULTRASONOGRAPHY IN BLUNT ABDOMINAL-TRAUMA - RESULTS IN 250 CONSECUTIVE CASES

The accuracy of ultrasonography (US) in detecting abdominal lesions an d free fluid collections in patients with blunt abdominal trauma was e valuated in 250 patients. Particular attention was paid to the role of associated US-guided paracentesis in doubtful cases and in those refe rred for nonsurgical therapy. The overall sensitivity of US in detecti ng free fluid collection was 98% (51 of 52 cases) with a specificity o f 99% and a positive predictive value of 100%. The overall sensitivity was 93% in spleen injuries, 80% in liver injuries, and 100% in kidney lesions with a positive predictive value of 93%, 100%, and 100%, and a specificity of 99%, 100%, and 100%, respectively. Three stable patie nts underwent celiotomy on the basis of the results of US-guided parac entesis. The versatility, sensitivity and, repeatability of US, along with its feasibility at bedside and the possibility of performing a gu ided paracentesis represent the main characteristics that make US the first diagnostic approach to patients with blunt abdominal trauma.