Normal ultrasound in abdominal trauma - clinical outcomes

ABSTRACT

Imaging plays an increasingly important role in trauma and the access to CT scans in more advanced centres has decreased the number of exploratory laparotomies. Ultrasound has not been given the status of CT scanning in trauma centres because it does not give a panoramic view of the abdomen, is operator dependent and surgeons are not as "comfortable" with the images generated. It is however cheaper and more readily available than CTs, especially in developing countries. The aim of this study is to determine the negative value of abdominal ultrasound in trauma. A retrospective study was done using data from the Ultrasound register of the Radiology Department and the Trauma Registry of the Department of Surgery for the period 1st August 1998 to 28th February 1999. Sixty-four (64) patients had normal abdominal ultrasounds twenty-four (24) for penetrating and forty (40) for blunt trauma. Fifteen (15) patients were female and forty-nine (49) male. Fifty-five (55) patients were discharged from A&E. Nine (9) patients were admitted to the ward of which eight (8) were subsequently discharged without surgical intervention. One (1) patient had an exploratory laparotomy which was negative for injury. No patient developed problems on follow-up. In this preliminary study, normal ultrasound in blunt or penetrating trauma had a 100 percent negative predictive value. We conclude that in competent hands, ultra-sound is useful in decreasing both the number of admissions to hospitals and the need for exploratory laparotomies.(AU)