Emergency department ultrasound in the evaluation of blunt abdominal trauma

Am J Emerg Med. 1993 Jul;11(4):342-6. doi: 10.1016/0735-6757(93)90164-7.


The main objective of this study was to compare bedside sonographic detection of hemoperitoneum with diagnostic peritoneal lavage/laparotomy in the patient with blunt abdominal trauma. A retrospective review was conducted of all blunt trauma patients that underwent emergency department (bedside) sonography to rule out intraperitoneal hemorrhage at a level I trauma center in 1991 to 1992. Patients were included in the study population only if: (1) the results of the ultrasound examination were interpreted before any other diagnostic studies, and (2) a diagnostic peritoneal lavage (DPL) or laparotomy was performed. The ultrasound examination consisted of a single right inter/subcostal longitudinal view with the patient in the trendelenburg position performed by the emergency physician or surgeon. A real-time sector scanner with a 3.5 MHz probe was used. The presence of an anechoic (black) stripe between the liver and the right kidney (Morrison's pouch) was interpreted as a positive study, and the absence of this finding was interpreted as a negative study. A positive DPL was defined as > or = 10 mL of gross blood or a blood cell count > or = 100,000/mm3 in the returned lavage fluid, and a positive laparotomy as > or = 100 mL of intraperitoneal blood. Forty-four patients met the inclusion criteria for the study. Eleven patients (24%) in this population had either a positive DPL or laparotomy. The sensitivity, specificity, and accuracy of bedside sonography in identifying intraperitoneal hemorrhage was 81.8%, 93.9%, and 90.9%, respectively. The ultrasound study provided an answer in less than 1 minute in most patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Injuries / complications
  • Abdominal Injuries / diagnostic imaging*
  • Adolescent
  • Adult
  • Emergency Service, Hospital
  • False Negative Reactions
  • False Positive Reactions
  • Hemoperitoneum / diagnosis*
  • Hemoperitoneum / diagnostic imaging
  • Hemoperitoneum / etiology
  • Humans
  • Male
  • Peritoneal Lavage*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / diagnostic imaging*