Routine abdominal sonography and computed tomography in multiple trauma patients. Analysis of therapy relevance in 105 patients

Introduction: A prospective analysis was done to determine the frequency of therapy relevance of abdominal computed tomography (CT) in multiple trauma patients in comparison to abdominal ultrasound (US). Methods: We recorded all multiple trauma patients in the emergency room (n = 248) from August 19 96 to July 1997 with an evaluation form and performed abdominal CT subseque nt to US whenever the patient was hemodynamically stable and not in need of immediate surgery (n = 105). We documented the results of both methods and their impact on acute therapy. Results: In 27 of 105 patients (25.7%) ther apy management was influenced by both either US or CT. 76 patients (72.4%) showed normal US findings, followed by a CT which showed additional finding s with therapeutic relevance in five patients (6.6%). Twenty-nine patients (27.6%) showed abnormal US findings. Compared to the therapeutic procedures proposed after the use of US the subsequently performed CT led to a change in therapy in 12 patients (41.4%). Conclusion: We conclude that if US is n ormal, additionally performed CT of the abdomen provides information of the rapeutic relevance in only a limited number of cases. If US is abnormal, CT will have an important impact on therapy in a high number of patients.