Evaluation of blunt abdominal trauma: the evolving role of ultrasound

ABSTRACT

To evaluate importance of ultrasonography in the operative management of patients after Blunt Abdominal Trauma. All the suspected cases of Blunt Abdominal Trauma attending the emergency Department of Civil Hospital Karachi from 1999 to 2001 are subjected to the ultrasonography of Abdomen along with other laboratory and radiological investigations apart from those who were hemodynamically unstable. Patients profile consists of a thorough history, physical examination, investigations and diagnosis were registered in the performa. One Hundred Patients of Blunt Abdominal Trauma were assessed by abdominal ultrasound to detect free fluid in abdomen as a result of solid organ injury, to take the decision of laparotomy as an emergency management. 95 patients underwent ultrasound examination. 5 patient left without ultrasound examination. Out of 95 patients, 90 patients did not show any positive findings related to intrabdominal injuries. 2 patients had splenic tear,1 suffered from liver tear and 2 patients had free fluid in the peritoneal cavity. 1 patient turned out to be false negative as he developed fever and peritonitis leading to laparotomy showing small bowel perforation. In our study the sensitivity and specificity of ultrasound examination for detecting intrabdominal injury in clinical stable patients of blunt trauma were 83.33% and 100% respectively. The following conclusions were derived after conducting this study Majority of the patients suffered from abdominal trauma are seen between 25- 44 years. Unrecognized abdominal injury remains a frequent cause of preventable death following blunt trauma. It can be prevented by the use of ultrasonography as it is cheap, easily repeatable and can be used at bed side. The results are operator dependant so ultrasound training will be incorporated into general surgical residency program