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Diagnostic value of a hand-carried ultrasound device for free intra-abdominal fluid and organ lacerations in major trauma patients
  1. Stephan Schleder1,
  2. Lena-Marie Dendl1,
  3. Antonio Ernstberger2,
  4. Michael Nerlich2,
  5. Patrick Hoffstetter1,
  6. Ernst-Michael Jung1,
  7. Peter Heiss1,
  8. Christian Stroszczynski1,
  9. Andreas G Schreyer1
  1. 1Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
  2. 2Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
  1. Correspondence to Dr Stephan Schleder, Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany; stephan.schleder{at}ukr.de

Abstract

Background Technological progress has led to the introduction of hand-carried ultrasound (HCU) imagers in clinical workflow. The aim of this study is to analyse whether examination with a HCU device is a rapid and reliable alternative to contrast-enhanced multidetector CT (MDCT) scans in diagnosis of free intra-abdominal fluid and organ lacerations in major trauma patients.

Methods 31 major trauma patients with an injury severity score >15 and the necessity of a MDCT scan (standard of reference) were enrolled prospectively to this study, and additionally examined with a HCU, according to ‘focused assessment with sonography for trauma’ principles for the assessment of organ lacerations and free intra-abdominal fluid. The HCU device employed was of the latest generation. Statistical analysis was performed using PASW V.18.

Results Four patients were diagnosed with free intra-abdominal fluid (prevalence 12.9%). HCU showed a sensitivity and specificity of 75% and 100%, respectively. Positive predictive value and negative predictive value were 100% and 96%, respectively. Five patients had organ lacerations (prevalence 16.1%). In these cases, the HCU was able to detect organ lacerations with a sensitivity and specificity of 80% and 100%, respectively. Therefore, a positive predictive value and negative predictive value of 100% and 96%, respectively, were calculated.

Conclusion In major trauma patients, examination with HCU according to the ‘focused assessment with sonography for trauma’ principles for the diagnosis of organ lacerations and free intra-abdominal fluid is a reliable and rapid alternative to MDCT scans and can help save precious time in emergency situations, and should, additionally, be evaluated in the pre-clinical workflow.

  • Diagnosis
  • major trauma
  • ultrasound
  • hand-carried ultrasound
  • free intra-abdominal fluid
  • organ laceration
  • pre-hospital care
  • abdomen

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Footnotes

  • Competing interests None.

  • Patient consent As only major trauma patients with an injury severity score >15 were included, only verbal informed consent could be obtained, and this was specifically approved by the ethics committee.

  • Ethics approval The ethics approval was provided by the Ethics Committee of the Medical Faculty, University Medical Centre Regensburg, Germany.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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