Patterns of fluid accumulation on screening ultrasonography for blunt abdominal trauma - Comparison with site of injury

The objectives of this study were to define where fluid accumulation is sho wn on screening ultrasonography after blunt abdominal trauma and to determi ne how fluid accumulation patterns are associated with the site of injury. From 1994 to 1998, 2693 screening examinations for blunt abdominal trauma w ere performed, in which 7 regions were examined for fluid. On the basis of a preliminary analysis of patients with solitary injuries, all 194 patients with sonographically detected fluid were grouped by fluid accumulation pat tern. Fluid patterns were compared with sites of injury The patterns differ ed between hepatic and splenic injuries. Fluid in the left upper quadrant, in both upper quadrants, or diffusely distributed suggested splenic injury, whereas fluid in the right upper quadrant or the right upper quadrant and lower recesses suggested hepatic injury (P < .0001). Fluid accumulation was random after enteric injury. Patients with extraperitoneal injury had no f luid or had fluid focally at the injury site. The ability to predict the in jury site on the basis of fluid patterns should expedite treatment of hemod ynamically unstable patients with blunt abdominal trauma.