جستجوی مقالات مرتبط با کلیدواژه « blunt abdominal trauma » در نشریات گروه « پزشکی »
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سابقه و هدف
ترومای شکمی یکی از شایع ترین علل مرگ در بیماران ترومایی است که در 20 درصد از موارد دیده می شود. آسیب کلیوی شایع ترین عارضه ترومای غیرنافذ شکمی است. در بیماران با ترومای شکمی، تشخیص سریع صدمات احتمالی داخل شکم و درمان آن اهمیت بسیاری دارد. وجود هماچوری و معاینات بالینی اغلب حساسیت و ویژگی کمی برای تشخیص آسیب داخل شکمی دارد. اگرچه سی تی اسکن روش استاندارد تشخیصی در بررسی ترومای شکمی است، عوارض و معایبی ازجمله دسترسی به سی تی اسکن و صرف زمان و پرتوگیری بیمار دارد. در مقابل، سونوگرافی روشی ارزان تر، قابل تکرار و غیرتهاجمی است. هدف از مطالعه حاضر تعیین ارزش تشخیصی سونوگرافی FAST، سونوگرافی توسط رادیولوژیست و مقایسه آن با سی تی اسکن شکم و لگن با کنتراست وریدی در تعیین شدت آسیب کلیوی بیماران دارای هماچوری میکروسکوپی به علت ترومای غیرنافذ شکم و لگن است.
مواد و روش هااین مطالعه به صورت آینده نگر در سال 1397 و 1398 در مرکز آموزشی درمانی بعثت همدان روی بیماران با ترومای غیرنافذ شکمی مبتلا به هماچوری انجام شد. نمونه گیری با روش سرشماری و بر اساس معیارهای ورود و خروج انجام شد. اطلاعات دموگرافیک بیماران و اطلاعات مربوط به حادثه منجر به ترومای شکمی در چک لیست ثبت شد. دستیار سال سوم طب اورژانس آموزش دیده و در مرحله بعد دستیار سال سوم یا چهارم رادیولوژی با نظارت متخصصان مربوطه، همه شرکت کننده ها را به منظور تشخیص مایع آزاد شکمی تحت سونوگرافی FAST قرار دادند. در مرحله بعد همه شرکت کننده ها بعد از تزریق ماده حاجب وریدی با استفاده از دستگاه سی تی اسکن بررسی شدند. داده ها با استفاده از روش آماری مناسب با استفاده از نرم افزار SPSS نسخه 22 تجزیه وتحلیل شدند.
یافته هادر این مطالعه 60 بیمار واجد شرایط شامل 47 مرد (78.4 درصد) و 13 زن (21.6 درصد) با میانگین سنی 17.81 ± 36.75 سال بررسی شدند. درصد توافق بین یافته های سونوگرافی FAST انجام شده در بخش اورژانس و رادیولوژی 93.3 درصد و توافق بین دو روش با ضریب توافق 0.837 معنادار بود (0.001>P). حساسیت (75 و 80)، اختصاصیت (100 و 92.5)، ارزش اخباری مثبت (100 و 84.2) و منفی (88.8 و 90.2) و دقت سونوگرافی FAST (91.6 و 88.3) در هر دو گروه اورژانس و رادیولوژی در مقایسه با سی تی اسکن قابل قبول بود.
نتیجه گیریبا توجه به نتایج به دست آمده می توان اظهار داشت که سونوگرافی FAST وسیله ای قابل اعتماد برای بررسی بیماران با ترومای بلانت شکمی مشکوک به آسیب کلیوی است.
کلید واژگان: آسیب کلیوی, اورژانس, ترومای بلانت شکم, سونوگرافی FAST, سی تی اسکن, هماچوری}Background and ObjectiveAbdominal trauma is one of the most common causes of death in trauma patients, occurring in 20% of cases. Kidney damage is the most common complication of non-penetrating abdominal trauma. In patients with abdominal trauma, it is important to diagnose and treat possible abdominal injuries. The presence of hematuria and clinical examinations often have little sensitivity and specificity to diagnose the intra-abdominal injury. Although Computed Tomography (CT) scan is the standard diagnostic method for abdominal trauma, it has its own drawbacks, including radiation. On the contrary, ultrasound is a cheaper, more repetitive, and non-invasive procedure. The present study aimed to determine the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) scan and ultrasound by a radiologist in comparison with abdomen and pelvis CT scan with intravenous (IV) contrast in determining the severity of kidney damage in patients with microscopic hematuria due to non-penetrating abdominal and pelvic trauma.
Materials and MethodsThis forward-looking study was conducted on patients with blunt abdominal trauma with hematuria in Hamadan Besat Educational and Medical Center in 2018 and 2019. The sampling was performed by census method based on inclusion and exclusion criteria. Patient demographic information, as well as accident information that led to abdominal trauma, were recorded in a checklist. All participants were trained by a third-year emergency medicine assistant and then by a third- or fourth-year radiology assistant via FAST ultrasound to diagnose free abdominal fluid. In the next step, all participants were examined after IV contrast injection using a CT scan device. Finally, the data were analyzed in SPSS software (version 22) using appropriate statistical methods.
ResultsIn this study, 60 eligible patients, including 47 males (78.4%) and 13 females (21.6%), with a mean age of 36.75±17.81 years, were examined. The percentage of agreement between the FAST ultrasound findings performed in the emergency and radiology departments was 93.3%. The agreement between the two methods was significant, with a coefficient of 0.837 (P<0.001). Sensitivity (75 and 80), specificity (100 and 92.5), positive (100 and 84.2) and negative (88.8 and 90.2) predictive values, as well as the accuracy (91.6 and 88.3) of FAST ultrasound, in both emergency and radiology groups were acceptable in comparison with CT scan.
ConclusionAs evidenced by the obtained results, it can be concluded that ultrasound is a reliable tool for examining patients with abdominal trauma with suspected kidney damage.
Keywords: Blunt abdominal trauma, CT scan, Emergency, FAST ultrasound, Hematuria, Kidney injury} -
BackgroundNon-operative management (NOM) has shown success in the management of cases of blunt abdominal trauma (BAT), especially in hemodynamically stable patients, even if there is a higher grade of injury.ObjectivesThe aim of this study was to determine the healing rate with NOM and associated risk factors of non-healing in patients with BAT.MethodsThis prospective study was conducted on 20 hemodynamically stable patients of BAT who were treated in a tertiary care hospital by NOM. Clinical monitoring and biochemical investigations were done. The patients were followed-up for three months. The outcome measures were the average time of healing and complications. A p-value less than 0.05 was considered statistically significant.ResultsThe mean age of the patients was 24.5 years with 18 (90%) males and 2(10%) females. Nine patients (45%) had isolated liver injury, 8 (40%) had isolated splenic injury, 1 (5%) had isolated left renal injury, 1 (5%) had combined liver and splenic injury and 1 (5%) had combined liver and right renal injury. At 3 months of follow-up, 16 (80%) cases showed complete healing, 3(15%) showed incomplete healing and 1 (5%) patient with grade 4 splenic injury had failure of NOM. On performing univariate regression analysis, grade 3/4 was an independent risk factor of non-healing with an odds ratio of 5.667.ConclusionIn conclusion, NOM appears to be a safe and effective management protocol for patients with BAT, provided regular follow-ups and monitoring are done.Keywords: Blunt Abdominal Trauma, Complications, Non-operative management}
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سابقه و هدف
استفاده از FAST در ترومای بلانت شکم مزایا و معایب مختلفی دارد. با توجه به اهمیت تشخیص به موقع تروماهای بلانت شکم این سوال مطرح می باشد که آیا می توان تنها با انجام FAST در اورژانس این بیماران را مدیریت نمود؟ لذا این پژوهش با هدف مقایسه صحت تشخیصی FAST با CT-Scan در بیماران با ترومای بلانت شکم انجام گردید.
مواد و روش هااین مطالعه مقطعی بر روی 400 بیمار با ترومای بلانت شکم مراجعه کننده به اورژانس بیمارستان های آموزشی دانشگاه علوم پزشکی کرمان در سال 1399 انجام شد. دستیابی به اطلاعات از طریق بررسی پرونده های پزشکی بیماران صورت گرفت. نتایج FAST با نتایج سی تی اسکن شکم و لگن (به عنوان استاندارد طلایی)، لاواژ تشخیصی پریتوین (Diagnostic Peritoneal Lavage= DPL) و نتایج لاپاراتومی (به عنوان استاندارد طلایی در صورت نامشخص بودن نتایج CT-Scan) مقایسه گردیدند و حساسیت، ویژگی، ارزش اخباری مثبت و منفی و دقت آن مشخص گردید.
یافته هامیانگین سن شرکت کنندگان برابر 10/44±36/27 سال بود. 72/5% آن ها مرد بودند. شایع ترین ارگان درگیر کبد (%73) بود. حساسیت، ویژگی، ارزش اخباری مثبت، ارزش اخباری منفی و دقت FAST به ترتیب برابر با 75/1 (79/6-73/4)، 91/7 (94/7-89/4)، 94/1 (96/3-92/7)، 77/2 (7/6-75/79) و 83/7 (85/5-80/3) بود. همچنین نسبت شانس FAST در تشخیص مایع آزاد برابر با 1335/3، آسیب ارگان های داخل شکمی برابر با 7/53 و برای کل موارد برابر با 28/9 بود.
نتیجه گیرینتایج مطالعه نشان داد که سونوگرافی FAST در اورژانس روش مناسبی برای تشخیص مایع آزاد داخل شکمی به دنبال ترومای بلانت بوده اما نمی تواند به خوبی محل آسیب را تشخیص دهد.
کلید واژگان: سونوگرافی FAST, سی تی اسکن, ترومای بلانت شکم}Background and ObjectiveThe use of Focused Assessment with Sonography in Trauma (FAST) in blunt abdominal trauma has various advantages and disadvantages. Considering the importance of timely diagnosis of blunt abdominal traumas, the question is whether it is possible to manage these patients only by performing FAST in the emergency room? Therefore, this study was conducted with the aim of comparing the diagnostic accuracy of FAST with CT-Scan in patients with blunt abdominal trauma.
MethodsThis cross-sectional study was conducted on 400 patients with blunt abdominal trauma referred to the emergency department of affiliated teaching hospitals of Kerman University of Medical Sciences in 2020. Data were obtained by examining the medical records of the patients. The results of FAST were compared with the results of abdominal and pelvic CT scan (as a gold standard), diagnostic peritoneal lavage (DPL) and laparotomy results (as a gold standard in case of unclear CT-Scan results) and the sensitivity, specificity, the positive and negative predictive value and its accuracy were determined.
FindingsThe mean age of the participants was 36.27±10.44 years. 72.5% of them were men. The most common organ involved was the liver (73%). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FAST were equal to 75.1 (73.4-79.6), 91.7 (89.4-94.7), 94.1 (92.7-96.3), 77.2 (75.7-79.6) and 83.7 (80.3-85.5), respectively. Also, the odds ratio of FAST in detecting free fluid was 1335.3, injury to intra-abdominal organs was 7.53 and it was 28.9 for all cases.
ConclusionThe results of the study showed that FAST sonography in the emergency room is a suitable method for diagnosing free intra-abdominal fluid following blunt trauma, but it cannot properly diagnose the location of the injury.
Keywords: FAST Ultrasound, CT Scan, Blunt Abdominal Trauma} -
BackgroundChildren with blunt abdominal trauma (BAT) can be risk stratified for intra-abdominal injury (IAI) through a combination of readily accessible clinical variables. The aim of this study was to identify ultrasound and laboratory studies that accurately identify IAI while limiting unnecessary CT-scan among children without injury.
Materials and MethodsWe conducted a prospective, observational study of 2-12 years old children with BAT who referred to the emergency department (ED) at Al-zahra and Kashani hospitals in Isfahan city, Iran, from January 2013 to May 2014. Children were undergone abdominal ultrasound and abdominal CT scan was done at the discretion of the treating physicians and according to the CT protocols. The tests obtained to assess for an IAI were including hematocrit (HCT), amylase, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) and urinalysis (U/A). The outcome were any IAI and intra-abdominal injury undergoing acute intervention (IAI-I).ResultsWe enrolled 101 children with a median age of 6.75 ± 3.2 years. There were 18 (17.8%) patients with IAI, and 5(5%) patients with IAI-I. The sensitivity, specificity and positive predictive value and negative predictive value of ultrasound compared to CT- scan were 72.2%, 85.5%, 52%, and 93.3%, respectively. It is notable that all 18 patients with IAI (Se=100%) had at least one positive test. The combination of ultrasound, ALT/AST, HCT, urinalysis and amylase tests (with at least one positive test) has negative predictive values of 100%.ConclusionIt can be argued that ultrasound combined with selected laboratory studies can be used to predict the risk of IAI accurately among children who sustain BAT. According to the results of this study, we can say that ultrasound and laboratory studies should be obtained as a screening tool in these cases.Keywords: Blunt abdominal trauma, Emergency department, pediatric, Ultrasound} -
BackgroundSpleen is the most common viscera that may be hurt in blunt abdominal trauma. Operative or nonoperative management of splenic injury is a dilemma. The American Association for the Surgery of Trauma (AAST) is the most common grading system which has been used for the management of blunt splenic injuries. The new recommended grading system assesses other aspects of splenic injury such as contrast extravasation, pseudoaneurysm, arteriovenous fistula, and severity of hemoperitoneum, as well. The aim of this study is to compare and prioritize the cutoff of AAST grading system with the new recommended one.Materials And MethodsThis is a cross‑sectional study on patients with splenic injury caused by abdominal blunt trauma referred to Isfahan University of Medical Sciences affiliated Hospitals, Iran, in 20132016. All patients underwent abdominopelvic computed tomography scanning with intravenous (IV) contrast. All images were reported by a single expert radiologist, and splenic injury grading was reported based on AAST and the new recommended system. Then, all patients were followed to see if they needed surgical or nonsurgical management.ResultsBased on the findings of this study conducted on 68 patients, cutoff point of Grade 2, in AAST system, had 90.3% (95% confidence interval [CI]: 0.730.97) specificity, 51.4% (95% CI: 0.340.67) sensitivity, 86.4% (95% CI: 0.640.95) positive predictive value (PPV), and 60.9% (95% CI: 0.450.74) negative predictive value (NPV) for prediction of surgical management requirement, while it was 90.3% (95% CI: 0.730.97) specificity, 45.9% (95% CI: 0.290.63) sensitivity, 85% (95% CI: 0.610.96) PPV, and 58.3% (95% CI: 0.430.72) NPV for the new system (P = 0.816).ConclusionIn contrast to the previous studies, the new splenic injury grading method was not superior to AAST. Further studies with larger populations are recommended.Keywords: Blunt abdominal trauma, injury grading system(s), splenic injury}
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Avulsion of Ampulla of Vater Secondary to a Blunt Abdominal Injury Treated with Pancreatoduodenectomy; A Case Report and Literature ReviewThe incidence of complex hepatobiliary injury secondary to blunt abdominal injuries varies between 3.4 and 5%. A 25-year old male patient underwent an urgent operation due to a motorcycle accident. During intraabdominal exploration, Grade 4 laceration was detected at the liver and bleeding was controlled through primary repair. In the postoperative seventh day, he was referred due to 1500 cc bile leakage from the drainage tube. During the operation, an extensive Kocher maneuver was done and the second part of duodenum was observed to be exposed to total avulsion from the head of the pancreas. Pancreatoduodenectomy was planned due to presence of ischemic changes in the second part of duodenum. In the postoperative follow-up, the abdomen was closed with a controlled abdominal closure procedure. The clinical findings of biliary tract injuries secondary to blunt abdominal injuries often manifest themselves late and early diagnosis is possible only with suspicion.Keywords: Ampulla vater, Blunt abdominal trauma, Duodenal trauma, Avulsion}
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Arterial pseudoaneurysm is an uncommon life-threatening complication in blunt trauma patients. Blunt liver injury may lead to hepatic artery pseudoaneurysm. Radiological intervention is the method of choice in diagnosis and treatment of hepatic artery pseudoaneurysm. However, surgical intervention is advised for unstable patients with large leaking defects. This study reports a case of 53-year-old female who was admitted with vague abdominal pain. She had experienced a blunt abdominal trauma a year ago and had gone under liver packing procedure. The CT-scan results showed hematoma in RUQ region and leaking pseudoaneurysm of right hepatic artery. Hematoma was drained and partial liver resection and hepatic arterioraphy were done through laparotomy.Keywords: Hepatic Artery, Pseudoaneurysm, Blunt Abdominal Trauma}
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Urology Journal, Volume:13 Issue: 6, Nov-Dec 2016, PP 2916 -2919PurposeAdrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children.The objective of this study was to analyze the prevalence of AGI in final diagnoses of trauma.Materials And MethodsThe records of 458 patients with abdominal trauma (out of a total 8,200 pediatric patientswith trauma of any sort), who were referred to our clinic between January 2009 and July 2014, were reviewed retrospectively.The numbers of patients with AGI and their ages, gender, trauma patterns, affected organs, pediatrictrauma scores (PTSs), and injury severity scores (ISSs) were recorded, as well as the associated ultrasound (US)and tomographic scan data, treatments, and complications. Computed tomography (CT) scans obtained after traumawere subjected to both primary and secondary evaluation.ResultsIn total, 28 patients with AGI were detected; their average age was 8.54 ± 4.09 (3-17) years. Twenty(71%) patients were male and 8 (29%) were female. Nineteen (68%) patients had fallen from heights; the mostcommonly injured organs were the kidneys, spleen, and lungs. Injuries were right-sided in 26 (92.9%) patients.The mean ISS was 13.2 (range 5-50) and the mean PTS 8.6 (range 0-11). Seven patients had ISS > 16 and ninehad PTSConclusionWe recommend calculation of the PTS, as well as other trauma scores, when pediatric patients sufferingmultiple or blunt abdominal trauma(s) present to the emergency . In addition, we believe that in children withtrauma involving the liver, spleen or kidneys, careful evaluation using a CT scan would increase the diagnosis ofAGI and reveal a realistic rate of AGI in trauma cases.Keywords: adrenal gland injury, blunt abdominal trauma, diagnosis, pediatric, prevalence}
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سابقه و هدفتروما یکی از چهار علت منجر به مرگ در کشورهای در حال توسعه مثل ایران است و دومین علت مرگ افراد جوان در کشور است. ارزیابی هدفمند بیماران ترومایی توسط سونوگرافی(FAST) بخشی از معاینه اولیه بسیار ارزشمند در مراقبت اورژانسی است. هدف از این مطالعه ارزیابی دقت FAST انجام شده در تشخیص مایع آزاد شکمی در بیماران ترومایی بخش اورژانس بوده است.مواد و روش هامطالعه مقطعی حاضر در سال 1393 روی 150 بیمار در بخش اورژانس مرکز آموزشی و درمانی امام خمینی(ره) ساری انجام شد. گزارش FAST انجام شده توسط دستیاران طب اورژانس با سی تی اسکن شکم و لگن با کنتراست خوراکی و وریدی برای بیماران ترومایی در تشخیص مایع آزاد شکمی مقایسه شد و مورد ارزیابی قرار گرفت و حساسیت و ویژگی و ارزش اخباری مثبت و منفی FAST در مقایسه با یافته های سی تی اسکن شکم و لگن اندازه گیری شد.یافته هامیانگین سنی بیماران 46/14±02/37 سال (بین 19 تا 91 سال) بود و 126 نفر (84 درصد) مرد و 24 نفر (16 درصد) زن بودند. FAST در 13 بیمار (7/8 درصد) و سی تی اسکن با کنتراست خوراکی و وریدی در 10 بیمار (7/6 درصد) مثبت گزارش شد (وجود مایع آزاد شکمی).
استنتاج: سونوگرافی (FAST) وسیله ای قابل اعتماد برای بررسی بیماران ترومایی است که با دقت قابل قبولی انجام می شود و با توجه به حضور دائم متخصصین طب اورژانس در لحظات اولیه بر بالین بیمار در تصمیم گیری بیماران ترومایی نقش به سزایی دارد.کلید واژگان: ترومای بلانت شکمی, سونوگرافی هدفمند در بیماران ترومایی, بخش اورژانس}Background andPurposeTrauma is the fourth leading cause of death in some developing countries and the second cause of death among young people in Iran. Focused assessment with sonography for trauma (FAST) as part of the preliminary examination is invaluable in emergency care. The aim of this study was to evaluate the accuracy of FAST in determining free abdominal fluid in traumatic patients admitted in an emergency department.Materials And MethodsA cross-sectional study was carried out in 150 trauma patients in emergency department (Imam Teaching Hospital, Sari, Iran). FAST reports for presence of free fluid in the abdomen by emergency residents were compared with those of abdominal and pelvic CT scan (oral and intravenous contrast). Sensitivity, specificity, positive predictive value and negative predictive value were evaluated.ResultsThe mean age of patients was 37.02 ± 14.46. There were 26 (84%) males and 24 (16%) females. In FAST and CT scan of the abdomen with oral and IV contrast 13 (8.7%) and 10 patients (6.7%) were reported with free fluid in the abdomen.ConclusionUltrasound is a reliable tool for assessing trauma patients that can be performed with reasonable accuracy. Emergency physicians are constantly available upon admission, therefore, ultrasound plays an important role in decisions made for trauma patients in emergency departments.Keywords: Blunt abdominal trauma, FAST, Emergency Department} -
ObjectiveTo determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma.MethodsThis was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients’medical records. Total 173 patients with HVI due to blunt abdominal trauma, who underwent laparotomy at our institute, were reviewed. Data regarding clinical presentation, anatomical distribution, management and outcome were recorded and analysed.ResultsOut of 173 patients 87.1% were men and 12.9% were women. Mean age of patients was 29 ± 14.02 years. The most common site of injury was ileum (46.2%) followed by jejunum (44.5%). There were 5 gastric perforations (2.9%), 2 (1.15%) duodenal, 2 (1.15%) colonic, 2 (1.15%) sigmoidal and 2 (1.15%) rectal injuries. One caecal injury was also recorded. Road traffic accident was the most common mechanism of injury (57.2%) followed by fall from height (36.4%) and assault (6.4%). Free gas under diaphragm on erect abdomen radiography was seen in 85.5% of cases while preoperative CT Abdomen was done in 11.6% of cases. Treatment consisted of simple closure of the perforation (66.5%), resection and anastomosis (11.0%) and stoma (22.5%). Major complication was anastamotic leak which was recorded in 6.4% cases and 15.6% patients developed burst abdomen. Average hospital stay was 13 ± 6 days. Overall mortality rate was 12.7%.ConclusionAlthough early recognition of intestinal injuries from blunt abdominal trauma may be difficult in all cases, it is very important due to its tremendous life threatening potential. Age of the patient, anatomical site and time of presentation are probably main prognostic factors.Keywords: Hollow viscus injury (HVI), Blunt abdominal trauma, Diagnostic modality, Complication, Mortality}
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ObjectivesTo identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.MethodsThis was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included adult (>14 years) patients with blunt abdominal trauma and intraperitoneal hemorrhage detected by CT-Scan who were hemodynamically stable and did not require any surgical intervention. Patients were managed conservatively in ICU. Those who required laparotomy during the study period were named as non-operative management failure (NOM-F) while the other were nonoperative management success (NOM-S). The baseline, clinical and laboratory characteristics were compared between two study groups in order to detect the predictors of successful NOM of intra-peritoneal bleeding.ResultsOverall we included 80 eligible patients among whom there were 55 (68.7%) men and 25 (31.3%) women with mean age of 30.63.6± years. Finally, 43 (53.8%) were successfully managed conservatively (NOM-S) while 37 (46.2%) required laparotomy (NOM-F). We found that those who underwent emergency laparotomy had significantly higher ĘHb (p=0.016) and lower base deficit (p=0.005) when compared to those who were successfully managed conservatively. Those who required surgical intervention had significantly lower baseline systolic blood pressure (p<0.001) and higher shock index (p=0.002). The other parameters such as pulse rate and respiratory rate were comparable between two study groups.ConclusionIn patients with intra-peritoneal bleeding following blunt abdominal trauma, the most reliable predictive clinical and para-clinical factor of successful non-operative management are shock index and systolic blood pressure on arrival, base deficit and hemoglobin drop within first 12 hours of admission.Keywords: Blunt abdominal trauma, Intra, peritoneal bleeding, Non, operative management, Conservative therapy}
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BackgroundBlunt abdominal trauma is one of the causes of mortality in emergency department. Free fluid in the abdomen due to intra-abdominal blunt trauma can be determined by the surface probe of ultrasound. Since the importance of this free fluid in hemodynamic stable patients with blunt trauma is associated with the unknown outcome for surgeons, this study was performed to evaluate the role of ultrasound surface probe as a screening method in evaluating the patients with blunt abdominal trauma.Materials And MethodsA descriptive-analytical study was done on 45 patients with blunt abdominal trauma and hemodynamic stability. The patients were evaluated twice during the three-hours, including repeated ultrasound surface probe and clinical examinations. Computerized tomography was also performed. The patients were divided based on the amount of the free fluid in the abdomen during the evaluations into two groups: Fixed or increased, and decreased free fluid. The results of the different evaluated methods were compared using the sensitivity and specificity.ResultsFrom 17 patients with CT abnormalities, free fluid increased in 14 patients (82.4%). Free fluid was decreased in three patients who were discharged well from the surgery service without any complication. Surface probe in prognosis detection had a sensitivity of 82.4% and specificity of 92.9%. The percentage of false positive and negative ultrasound compared with CT scan was 7.1% and 17.6%. Also, positive and negative predictive value of the ultrasound with surface probe was 87.5% and 89.7% respectively.ConclusionThe use of the ultrasound with surface probe in the diagnosis of free fluid in blunt abdominal trauma in hemodynamic stable patients can be considered as a useful screening method.Keywords: Blunt abdominal trauma, CT scan, ultrasound surface probe}
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