Evaluation of hemoperitoneum using a single- vs multiple-view ultrasonographic examination.

Oscar Ma, M. P. Kefer, J. R. Mateer, B. Thoma

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To compare the sensitivities, specificities, and accuracies between a single-view ultrasonography (US) technique and a multiple-view technique for identifying hemoperitoneum in multiple-trauma patients. METHODS: Data from a prior prospective study of US for trauma diagnosis at a level I trauma center were retrospectively analyzed. A convenience sample of adult patients (> or = 18 years of age) who had presented with major blunt or penetrating torso trauma and had undergone rapid trauma US examinations to detect hemoperitoneum were reviewed. The US interpretations by emergency physicians had been recorded prior to obtaining other diagnostic tests. Five views were evaluated, including the right intercostal oblique view examining Morison's pouch. Evidence of free intraperitoneal fluid by exploratory laparotomy, CT, or diagnostic peritoneal lavage (DPL) was used as the criterion standard. RESULTS: Of the 245 patients entered into the study, 37 had free intraperitoneal fluid, confirmed by CT, DPL, or exploratory laparotomy. With the multiple-view technique, US was 87% (95% CI = 71%, 96%) sensitive, 100% (95% CI = 97%, 100%) specific, and 98% (95% CI = 95%, 100%) accurate. The single-view technique, evaluating only Morison's pouch, was 51% (95% CI = 34%, 68%) sensitive, 100% (95% CI = 98%, 100%) specific, and 93% (95% CI = 89%, 96%) accurate. CONCLUSIONS: An initial trauma US examination using a multiple-view technique is more sensitive than that using a single-view technique for detecting hemoperitoneum in trauma patients.

Original languageEnglish (US)
Pages (from-to)581-586
Number of pages6
JournalAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine
Volume2
Issue number7
StatePublished - Jul 1995
Externally publishedYes

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Hemoperitoneum
Ultrasonography
Wounds and Injuries
Peritoneal Lavage
Laparotomy
Torso
Multiple Trauma
Trauma Centers
Routine Diagnostic Tests
Emergencies
Prospective Studies
Physicians
Sensitivity and Specificity

ASJC Scopus subject areas

  • Emergency Medicine

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Evaluation of hemoperitoneum using a single- vs multiple-view ultrasonographic examination. / Ma, Oscar; Kefer, M. P.; Mateer, J. R.; Thoma, B.

In: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, Vol. 2, No. 7, 07.1995, p. 581-586.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To compare the sensitivities, specificities, and accuracies between a single-view ultrasonography (US) technique and a multiple-view technique for identifying hemoperitoneum in multiple-trauma patients. METHODS: Data from a prior prospective study of US for trauma diagnosis at a level I trauma center were retrospectively analyzed. A convenience sample of adult patients (> or = 18 years of age) who had presented with major blunt or penetrating torso trauma and had undergone rapid trauma US examinations to detect hemoperitoneum were reviewed. The US interpretations by emergency physicians had been recorded prior to obtaining other diagnostic tests. Five views were evaluated, including the right intercostal oblique view examining Morison's pouch. Evidence of free intraperitoneal fluid by exploratory laparotomy, CT, or diagnostic peritoneal lavage (DPL) was used as the criterion standard. RESULTS: Of the 245 patients entered into the study, 37 had free intraperitoneal fluid, confirmed by CT, DPL, or exploratory laparotomy. With the multiple-view technique, US was 87{\%} (95{\%} CI = 71{\%}, 96{\%}) sensitive, 100{\%} (95{\%} CI = 97{\%}, 100{\%}) specific, and 98{\%} (95{\%} CI = 95{\%}, 100{\%}) accurate. The single-view technique, evaluating only Morison's pouch, was 51{\%} (95{\%} CI = 34{\%}, 68{\%}) sensitive, 100{\%} (95{\%} CI = 98{\%}, 100{\%}) specific, and 93{\%} (95{\%} CI = 89{\%}, 96{\%}) accurate. CONCLUSIONS: An initial trauma US examination using a multiple-view technique is more sensitive than that using a single-view technique for detecting hemoperitoneum in trauma patients.",
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