Usefulness and limitations of ultrasonography in the initial evaluation of blunt abdominal trauma

被引:102
作者
Yoshii, H
Sato, M
Yamamoto, S
Motegi, M
Okusawa, S
Kitano, M
Nagashima, A
Doi, M
Takuma, K
Kato, K
Aikawa, N
机构
[1] Saiseikai Kanagawaken Hosp, Dept Surg, Kanagawa Ku, Yokohama, Kanagawa 221, Japan
[2] Saiseikai Kanagawaken Hosp, Dept Radiol, Kanagawa Ku, Yokohama, Kanagawa 221, Japan
[3] Saiseikai Kanagawaken Hosp, Dept Emergency Med, Kanagawa Ku, Yokohama, Kanagawa 221, Japan
[4] Keio Univ, Sch Med, Dept Emergency & Crit Care Med, Tokyo, Japan
关键词
blunt abdominal trauma; ultrasonography; diagnostic usefulness; diagnostic limitations;
D O I
10.1097/00005373-199807000-00009
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: In the assessment of blunt abdominal trauma, the reliability of ultrasonography (US) in identifying individual organ injuries remains uncertain, in spite of its usefulness in detecting hemoperitoneum. This study was designed to evaluate the overall diagnostic value of US, including identification of individual organ injuries. Methods: The accuracy of US in the detection of intra-abdominal injuries and the identification of individual organ injuries was evaluated in 1,239 patients seen during a 15-year period. Accuracy was based on detection of intraperitoneal fluid, free air, or irregular parenchymal lesions. Results: For the detection of injuries, US was 94.6% sensitive, 95.1% specific, and 94.9% accurate, Individual organ injuries were identified with sensitivities of 92.4, 90.0, 92.2, 71.4, and 34.7% for the liver, spleen, kidneys, pancreas, and intestine, respectively. Conclusion: US is reliable for the detection of injuries and the identification of solid-organ injuries despite its poor sensitivity for intestinal injuries.
引用
收藏
页码:45 / 50
页数:6
相关论文
共 24 条
[1]  
ALYONO D, 1982, SURGERY, V92, P751
[2]   ABDOMINAL ULTRASOUND AS A RELIABLE INDICATOR FOR CONCLUSIVE LAPAROTOMY IN BLUNT ABDOMINAL-TRAUMA [J].
BODE, PJ ;
NIEZEN, RA ;
VANVUGT, AB ;
SCHIPPER, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1993, 34 (01) :27-31
[3]   Emergent abdominal sonography as a screening test in a new diagnostic algorithm for blunt trauma - Discussion [J].
Rozycki, G ;
Boulanger, BR .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1996, 40 (06) :874-874
[4]   AAST ORGAN INJURY SCALE - CORRELATION OF CT-GRADED LIVER INJURIES AND OPERATIVE FINDINGS [J].
CROCE, MA ;
FABIAN, TC ;
KUDSK, KA ;
BAUM, SL ;
PAYNE, LW ;
MANGIANTE, EC ;
BRITT, LG .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1991, 31 (06) :806-812
[5]   DIAGNOSTIC PERITONEAL-LAVAGE - INTEGRATION WITH CLINICAL INFORMATION TO IMPROVE DIAGNOSTIC PERFORMANCE [J].
DAY, AC ;
RANKIN, N ;
CHARLESWORTH, P .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1992, 32 (01) :52-57
[6]   A PROSPECTIVE-STUDY OF 91 PATIENTS UNDERGOING BOTH COMPUTED-TOMOGRAPHY AND PERITONEAL-LAVAGE FOLLOWING BLUNT ABDOMINAL-TRAUMA [J].
FABIAN, TC ;
MANGIANTE, EC ;
WHITE, TJ ;
PATTERSON, CR ;
BOLDREGHINI, S ;
BRITT, LG .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1986, 26 (07) :602-608
[7]   THE DIAGNOSTIC SUPERIORITY OF COMPUTERIZED-TOMOGRAPHY [J].
GOLDSTEIN, AS ;
SCLAFANI, SJA ;
KUPFERSTEIN, NH ;
BASS, I ;
LEWIS, T ;
PANETTA, T ;
PHILLIPS, T ;
SHAFTAN, GW .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1985, 25 (10) :938-946
[8]   THE ROLE OF ULTRASONOGRAPHY IN BLUNT ABDOMINAL-TRAUMA - RESULTS IN 250 CONSECUTIVE CASES [J].
GOLETTI, O ;
GHISELLI, G ;
LIPPOLIS, PV ;
CHIARUGI, M ;
BRACCINI, G ;
MACALUSO, C ;
CAVINA, E .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1994, 36 (02) :178-181
[9]  
GRUESSNER R, 1989, J TRAUMA, V29, P242
[10]   EARLY DIAGNOSIS OF SMALL-INTESTINE RUPTURE FROM BLUNT ABDOMINAL-TRAUMA USING COMPUTED-TOMOGRAPHY - SIGNIFICANCE OF THE STREAKY DENSITY WITHIN THE MESENTERY [J].
HAGIWARA, A ;
YUKIOKA, T ;
SATOU, M ;
YOSHII, H ;
YAMAMOTO, S ;
MATSUDA, H ;
SHIMAZAKI, S .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1995, 38 (04) :630-633