A PROSPECTIVE-STUDY OF EMERGENT ABDOMINAL SONOGRAPHY AFTER BLUNT TRAUMA

In North America, the role of emergent abdominal sonography [ultrasono graphy (US)] after blunt trauma requires further definition. The purpo se of this prospective study was to compare US to the gold standards, diagnostic peritoneal lavage (DPL), and computed tomography (CT), in a population of adults after blunt trauma. In 206 adults who required e ither CT or DPL to assess possible abdominal injury, US was performed, before DPL or CT, and was aimed at the detection of intraperitoneal f luid. The mean Injury Severity Score and Glasgow Coma Scale score were 24.0 and 11.9, respectively. One hundred thirty-seven patients (67%) had CT and 69 (33%) had DPL. The positive and negative predictive valu es of US for intraperitoneal fluid were 90% and 97%, respectively. The sensitivity, specificity, and accuracy of US for free fluid were 81%, 98%, and 96%, respectively. Of the six false-negative USs, only one r equired surgery. The US examinations required 2.6 +/- 1.4 min. Emergen t abdominal sonography is an accurate, rapid test for the presence of intraperitoneal fluid in adult blunt trauma victims and in these patie nts may prove valuable as a screening test for abdominal injury.