Ultrasonography in the evaluation of hemoperitoneum in war casualties

The aim of this study was to evaluate the sensitivity, specific ity, accura cy, and positive and negative predictive values of emergent ultrasound exam ination in the detection of hemoperitoneum among war casualties, and to com pare the results of this method in a specific war situation and civil condi tions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrason ographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false -positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed th at ultrasonography in specific war conditions showed sensitivity of 86%, sp ecificity of 100%, accuracy as high as 97%, positive predictive value of 10 0%, and negative predictive value of 96%, whereas in civil conditions the c orresponding Values were 88%, 100%, 95%, 100%, and 91%, respectively. The s ensitivity, specificity, accuracy, and positive and negative predictive val ues of emergent ultrasound examination in the diagnosis of hemoperitoneum a re approximately equal in war and civil conditions.