Abdominal Ultrasound is an Unreliable Modality for the Detection of Hemoperitoneum in Patients With Pelvic Fracture

• DOI: 10.1097/ta.0b013e31805f6ffb
• Publication Date: 2007-07-10T08:03:37Z
• Authors: Randall S. Friese; Stephen Malekzadeh; Shahid Shafi; Larry M. Gentilello; Adam Starr
• Keywords: Hemoperitoneum; Pelvic fracture; Trauma Center; Blunt trauma; Diagnostic peritoneal lavage

Detection of hemoperitoneum in patients with pelvic fracture and hemodynamic instability is important to determine the need for laparotomy versus angiography. The use ultrasound (FAST [Focused Assessment Sonography Trauma]) evaluation after blunt abdominal trauma has become widespread. However, its sensitivity specificity remain poorly defined. purpose this study was FAST detection an increased risk hemorrhage.The medical records all admissions our Level I center from November 2003 February 2005 were retrospectively reviewed. Inclusion criteria presence at least one following factors hemorrhage: age > or =55, hemorrhagic shock (systolic blood pressure <100 mm Hg), unstable pattern. Emergency department results recorded. Surgery residents trained certified ultrasonography acute setting performed examinations house attending surgeon reviewed them. Presence confirmed by abdominopelvic computed tomography (CT) scan.There 146 who met entry criteria, 126 had a examination performed. A total 104 underwent confirmatory their abdomen either operative exploration (n = 20) CT scan 84). Eight diagnostic peritoneal lavage before confirmation excluded. Ninety-six constituted group. Nineteen presented shock. There 11 true-positive, 52 true-negative, 2 false-positive, 31 false-negative results. Sensitivity 26% 96%, respectively. Positive negative predictive values 85% 63%, respectively.A result does not aid determining angiography hemorrhage. These should undergo additional exclude intraperitoneal