Evaluation of ultrasound, lavage, and computed tomography in blunt abdominal trauma.

We have analysed the data of 136 patients with multiple injuries treated between 1983 and 1988 in order to assess the sensitivity, specificity, and accuracy of ultrasound, lavage and computed tomography (CT) for the preoperative diagnosis of blunt abdominal trauma. CT was carried out in doubtful cases (n = 29) if ultrasound and lavage had not provided sufficient information. Fifty-eight patients were primarily excluded from the study because neither clinical examination nor ultrasound gave any sign of an intra-abdominal lesion. In 25 cases, sonography could be compared with lavage, CT, and the intraoperative situs. Ultrasound showed reliable results in respect to accuracy (100%), sensitivity (84%), and specificity (98%). Computed tomography confirmed all sonographic diagnoses in 29 patients but did not provide further information. Peritoneal lavage gave correct information in all patients operated upon. Our 5-years' experience suggests that ultrasound is a reliable, quick, cheap, and repeatable technique of great value in patients with blunt abdominal traumata.