Abstract
This study's objective was to analyze whether the quantity of free intraperitoneal
fluid on ultrasonography, alone or in combination with unstable vital signs, is sensitive
in determining the need for laparotomy in patients presenting with blunt trauma. Adult
patients who presented with blunt abdominal trauma to 2 level I trauma centers were
enrolled. Combined intraperitoneal fluid levels (anechoic stripe) of 5 intraperitoneal
areas were measured and defined as small (< 1.0 cm), moderate (> 1.0 cm, < 3.0 cm),
or large (> 3.0 cm). Unstable vital signs were defined as pulse > 100 bpm or systolic
blood pressure < 90 mmHg. Exploratory laparotomy or computed tomography scan confirmed
hemoperitoneum. Of 270 patients entered into the study, ultrasound detected free intraperitoneal
fluid in 33 patients. Of the 18 patients with a large fluid accumulation, 16 underwent
exploratory laparotomy (89% sensitivity), and all 8 patients with unstable vital signs
underwent exploratory laparotomy (100% sensitivity). Of the 10 patients with a moderate
fluid accumulation, 6 underwent exploratory laparotomy (60% sensitivity), and 4 of
the 6 patients with unstable vital signs underwent exploratory laparotomy (67% sensitivity).
A large intraperitoneal fluid accumulation on ultrasonography in combination with
unstable vital signs, is sensitive for determining the need for exploratory laparotomy
in patients presenting with blunt trauma. (Am J Emerg Med 2001;19:284-286. Copyright
© 2001 by W.B. Saunders Company)
Keywords
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Article Info
Publication History
Accepted:
December 30,
2000
Received:
November 10,
2000
Footnotes
☆Address reprint requests to O. John Ma, MD, Department of Emergency Medicine, Truman Medical Center, 2301 Holmes St, Kansas City, MO 64108. E-mail: [email protected]
☆☆Am J Emerg Med 2001;19:284-286
★0735-6757/01/1904-0007$35.00/0
Identification
Copyright
© 2001 W.B. Saunders Company. Published by Elsevier Inc. All rights reserved.
