Evaluating an Ultrasound Algorithm for Patients with Blunt Abdominal Trauma

The ideal assessment of the blunt abdominal trauma (BAT) patient would be sensitive, specific, economical, fast, and without complications. By combining ultrasound (US) with computed tomography (CT) and diagnostic peritoneal lavage (DPL), an effective algorithm can be derived to accurately evaluate BAT. We prospectively evaluated a series of patients with suspected blunt abdominal trauma using an algorithm with ultrasound as the initial screening modality to determine if it would be more sensitive, specific, and costeffective than each diagnostic modality alone. Methods: One hundred ninety-one patients over the age of 18 with suspected BAT were evaluated according to an established algorithm. Ultrasound was the initial diagnostic technique. Results: In this study, US had a sensitivity of 84.0%, a specificity of 98.7, and an accuracy of 96.7%. CT had a sensitivity of 100%, a specificity of 100% and an accuracy of 100%. The algorithm had a sensitivity of 100%, a specificity of 98.7% and an accuracy of 99.0%. Of the patients entered in the study, 9% received a laparotomy. The non-therapeutic laparotomy rate was 11%. Conclusions: An algorithm for blunt abdominal trauma that utilizes ultrasound as the initial diagnostic technique can accurately assess intrabdominal hemorrhage in unstable patients and act as a screening tool for computed tomography in stable patients.