Ultrasonographic diagnosis of abdominal free fluid: accuracy comparison of emergency physicians and radiologists
- PDF / 229,264 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 146 Views
ORIGINAL ARTICLE
Ultrasonographic diagnosis of abdominal free fluid: accuracy comparison of emergency physicians and radiologists S. Tajoddini • S. Shams Vahdati
Received: 10 April 2012 / Accepted: 31 July 2012 / Published online: 5 September 2012 Ó Springer-Verlag 2012
Abstract Objective Blunt abdominal trauma is a diagnostic challenge for emergency physicians and ultrasonography is one of the diagnostic tools used in this type of injuries. The aim of this study was to evaluate the diagnostic value of ultrasonographies performed by emergency physicians and radiologists. Methods This prospective diagnostic study was performed in the emergency departments of two trauma centers in Iran during a period of 12 months. The subjects were all patients with blunt abdominal trauma that were candidated for abdominopelvic computed tomography (CT) scanning in our emergency departments. The results of focused assessment with sonography for trauma (FAST) performed by emergency physicians and radiologists were compared blindly with the results of CT scans performed by radiologists. The sensitivity, specificity, and predictive values of diagnosis for different abdominal anatomic areas were calculated. Results In total, 450 patients undergoing FAST and CT scanning were studied. The sensitivity of radiologists’ diagnoses for Morison’s, splenorenal, perivesical, and pleural effusion areas were, respectively, 88.0, 70.0, 38.0, and 30.0 %. The corresponding values for emergency physicians’ diagnoses were, respectively, 82.0, 60.0, 28.0, and 30.0 %. The specificity of radiologists’ diagnoses in the mentioned areas were, respectively, 98.9, 100, 93.1, S. Tajoddini (&) Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran e-mail: [email protected]; [email protected] S. Shams Vahdati Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
and 100 %, and for emergency physicians, they were, respectively, 98.9, 100, 96.0, and 100 %. Conclusion Emergency physicians showed a promising performance in applying FAST in blunt abdominal trauma. The specificity of ultrasonographic diagnosis in the emergency physicians group and the radiologists group were comparable, while radiologists showed a higher performance regarding the sensitivity of the ultrasonographic diagnosis. Keywords Blunt abdominal injury Emergency medicine Ultrasound FAST Focused assessment with sonography for trauma
Introduction Blunt traumas have been always a challenging issue for emergency physicians and emergency ultrasonography has provided a novel valid tool for the diagnosis of intraabdominal injuries. Abdominal traumas are the third most common cause of mortality due to trauma in children and adults [1] and non-diagnosed intra-abdominal injury is considered as one of the preventable causes of death. Since 1980, in several studies [2–7], ultrasonography has been suggested as a diagnostic tool for emergency physicians and, since 2002, in almost all emergency medicine residency educatio
Data Loading...
