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Focused Assessment with Sonography for Trauma (FAST) Exam: Image Acquisition
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Performance of abdominal ultrasonography in pediatric blunt trauma patients: a meta-analysis

James F Holmes1, Aaron Gladman, Cindy H Chang

  • 1Department of Emergency Medicine, UC Davis School of Medicine, Davis, Sacramento, CA 95817, USA. jfholmes@ucdavis.edu

Journal of Pediatric Surgery
|September 13, 2007
PubMed

Insights

Abdominal ultrasonography (US) shows moderate accuracy in detecting intra-abdominal injuries (IAIs) in children. Its effectiveness decreases with more rigorous study analysis, suggesting it shouldn't be the sole diagnostic tool.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Trauma Surgery

Background:

  • Intra-abdominal injuries (IAIs) are a significant concern in pediatric blunt trauma.
  • Accurate and timely diagnosis is crucial for effective management and improved outcomes.
  • Abdominal ultrasonography (US) is a widely used imaging modality in evaluating these patients.

Purpose of the Study:

  • To determine the optimal test performance estimates of abdominal US for identifying IAIs in children.
  • To evaluate the diagnostic accuracy of abdominal US in pediatric blunt trauma patients.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (MEDLINE, Embase) and other sources.
  • Included prospective and retrospective studies evaluating abdominal US for detecting intraperitoneal fluid or IAIs in blunt trauma patients under 18.
  • Data abstraction was performed independently by multiple authors to ensure reliability.

Main Results:

  • Twenty-five articles comprising 3838 children were analyzed.
  • Overall, abdominal US demonstrated a sensitivity of 80% and specificity of 96% for detecting hemoperitoneum.
  • However, analysis of the most methodologically rigorous studies showed reduced test characteristics: 66% sensitivity and 95% specificity.

Conclusions:

  • Abdominal US has a modest sensitivity for detecting hemoperitoneum in children, with performance declining in high-quality studies.
  • A negative US result alone is insufficient to rule out IAIs.
  • Hemodynamically stable children with a positive US finding require immediate abdominal computed tomographic (CT) scanning due to the high risk of IAI.
Abstract

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