2,576 ultrasounds for blunt abdominal trauma

Backgroud: Determination of intraabdominal injury following blunt abdominal trauma (BAT) continues to be a diagnostic challenge, Ultrasound (US) has b een described as a potentially useful diagnostic tool in this setting and i s being used with increasing frequency in trauma centers. We determined the diagnostic capability of US in the evaluation of EAT. Methods: A retrospective analysis of our trauma US database was performed o ver a 30 month period. Computed tomographic scan, diagnostic peritoneal lav age, or exploratory laparotomy confirmed the presence of intra-abdominal in jury. Results: During the study period, 8,197 patients were evaluated at the Ryde r Trauma Center. Of this group, 2,576 (31%) had US in the evaluation of BAT . Three hundred eleven (12%) US exams were considered positive. Forty-three patients (1.7%) had a false-negative US; of this group, 10 (33%) required exploratory laparotomy. US had a sensitivity of 86%, a specificity of 98%, and an accuracy of 97% for detection of intra-abdominal injuries. Positive predictive value was 87% and negative predictive value was 98%. Conclusion: Emergency US is highly reliable and may replace computed tomogr aphic scan and diagnostic peritoneal lavage as the initial diagnostic modal ity in the evaluation of most patients with BAT.