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Related Experiment Videos

The indeterminate abdominal sonogram in multisystem blunt trauma

B R Boulanger1, F D Brenneman, A W Kirkpatrick

  • 1Department of Surgery, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.

The Journal of Trauma
|July 29, 1998
PubMed
Summary

Indeterminate (IND) sonograms in blunt trauma are uncommon (6.7%) and often due to patient factors. These sonograms require further investigation, leading to increased diagnostic time and potential laparotomy.

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Area of Science:

  • Emergency Medicine
  • Diagnostic Imaging
  • Trauma Surgery

Background:

  • Emergent torso sonography has limitations in North American trauma centers.
  • Indeterminate (IND) sonograms present a diagnostic challenge in blunt trauma assessment.

Purpose of the Study:

  • To evaluate the frequency, causes, associations, and sequelae of indeterminate sonograms in blunt trauma patients.
  • To understand the clinical implications of IND sonograms in trauma care.

Main Methods:

  • Prospective study of adult blunt trauma patients undergoing screening torso sonography.
  • Sonograms classified as positive, negative, or IND for free fluid.
  • IND sonograms investigated with repeat sonography, CT, or diagnostic peritoneal lavage.

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Main Results:

  • 6.7% of 417 blunt trauma patients had IND sonograms.
  • IND sonograms primarily caused by patient factors (71%) and operator factors (29%).
  • IND group had significantly longer diagnostic workup times (117 vs. 48 minutes).

Conclusions:

  • IND sonograms are infrequent but necessitate further investigation.
  • Patient factors commonly lead to IND sonograms.
  • IND sonograms are associated with increased diagnostic time and may indicate injuries requiring laparotomy.