BLUNT ABDOMINAL-TRAUMA IN CHILDREN - THE PRACTICAL VALUE OF ULTRASONOGRAPHY

The occult nature of blunt abdominal trauma justifies the need for rel iable diagnostic adjuncts to physical examination. From June 1988 to J une 1991, 259 children admitted to the general surgery/trauma service underwent abdominal ultrasonographic scanning (US). A total of 116 abd ominal lesions were found in 81 patients. Ultrasonography alone had a sensitivity of 89%, a specificity of 96%, and an overall accuracy of 9 4%, as determined against the overall diagnostic workup and clinical c ourse (mean follow-up, 17.4 weeks). In 44% of the patients, US was use d alone; in 49% one or two additional tests were performed, and in onl y 7% were three or more tests required. Compared with computed tomogra phy, US is more versatile, easier to perform in children, and more cos t effective, even with the addition of a functional imaging modality. Although not demonstrated by this preliminary, retrospective study, Do ppler US appears to be the logical complement to abdominal ultrasonogr aphy in the evaluation of children with blunt abdominal trauma.