Ultrasonography in the Management of Blunt Abdominal and Thoracic Trauma

Karl Glaser, MD; Jörg Tschmelitsch, MD; Paul Klingler, MD; Gerald Wetscher, MD; Ernst Bodner, MD
Arch Surg. 1994;129(7):743-747. doi:10.1001/archsurg.1994.01420310075013.
Text Size: A A A
Published online

Objective:  To assess the sensitivity, specificity, and predictive value of ultrasonography in patients with blunt abdominal or thoracic trauma in regard to the indication for immediate operation, delayed abdominal exploration, or conservative treatment.

Design:  A retrospective study was conducted after consecutive sampling of 1151 patients in a nonrandomized control trial.

Setting:  The study was conducted at the University Hospital of Innsbruck (Austria), which serves as a general community hospital and a major primary care and referral center.

Patients:  All patients with blunt abdominal or thoracic trauma with or without polytraumatization were eligible for the study; a total of 1151 patients were observed from 1980 to 1990. According to the ultrasonographic findings, patients were divided into three groups: immediate operation, primary conservative treatment, and conservative treatment (normal ultrasonographic findings). Ultrasonography was repeated when the clinical findings or laboratory test results showed the development of intra-abdominal hemorrhage or signs of organ laceration.

Intervention:  Ultrasonography in the emergency department or intensive care unit.

Main Outcome Measures:  Conservative or operative treatment based on ultrasonographic and clinical findings.

Results:  Ultrasonography showed a sensitivity of 99%, a specificity of 98%, a positive predictive value of 0.97, and a negative predictive value of 0.99 in regard to the indication for surgery in cases of blunt abdominal or thoracic trauma. Ultrasonography is not reliable in patients with intestinal perforation and large retroperitoneal hematomas.

Conclusion:  Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the method of first choice in the evaluation of blunt trauma.(Arch Surg. 1994;129:743-747)


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.