[Management of sonography in blunt abdominal trauma]

A standardized management of sonography in blunt abdominal trauma has replaced peritoneal lavage in our department. The sonographic evaluation is performed simultaneously with additional diagnostic and therapeutic procedures in the emergency room. The primary goal is the exclusion of intraabdominal bleeding. The management and the results of the diagnostic procedure are presented with reference to a consecutive series of 314 patients with blunt abdominal trauma or polytrauma. In 71 patients, laparotomy was performed because the sonographic findings were felt to indicate it. Only in two cases was the sonographic assessment incorrect (false-positive). Frequent sonographic and clinical controls are required especially when sonography cannot totally exclude intraabdominal bleeding during the initial assessment. If any discrepancies between negative or uncertain sonographic and suspect clinical findings remain, further high-tech diagnostic methods or exploratory laparotomy become necessary.