Faruque Ahmad Vaqas, Qazi Saqib Hamid, Khan Muhammad Arif Mateen, Akhtar Wassem, Majeed Amina
Section of Paediatric Surgery, Department of Surgery, The Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2013 Mar;63(3):361-4.
To evaluate the role of focussed abdominal sonography for trauma in blunt paediatric abdominal trauma patients, and to see if the role of computed tomography scan could be limited to only those cases in which sonography was positive.
The retrospective study covered 10 years, from January 1,2000 to December 31,2009, and was conducted at the Department of Radiology and Department of Emergency Medicine, Aga Khan University Hospital, Karachi. It comprised cases of 174 children from birth to 14 years who had presented with blunt abdominal trauma and had focussed abdominal sonography for trauma done at the hospital. The findings were correlated with computed tomography scan of the abdomen and clinical follow-up. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of focussed abdominal sonography for trauma were calculated for blunt abdominal trauma. SPSS 17 was used for statistical analysis.
Of the total 174 cases, 31 (17.81%) were later confirmed by abdominal scan. Of these 31 children, sonography had been positive in 29 (93.54%) children. In 21 (67.74%) of the 31 children, sonograpy had been true positive; 8 (25%) (8/31) were false positive; and 2 (6%) (2/31) were false negative. There were 6 (19.3%) children in which sonography was positive and converted to laparotomy. There was no significant difference on account of gender (p>0.356). Focussed abdominal sonography for trauma in the study had sensitivity of 91%, specificity of 95%, positive predictive value of 73%, and negative predictive value of 73% with accuracy of 94%. All patients who had negative sonography were discharged later, and had no complication on clinical follow-up.
Focussed abdominal sonography for trauma is a fairly reliable mode to assess blunt abdominal trauma in children. It is a useful tool to pick high-grade solid and hollow viscous injury. The results suggest that the role of computed tomography scan can be limited to those cases in which focussed sonography is positive.
评估聚焦腹部超声检查在小儿钝性腹部创伤患者中的作用，并探讨计算机断层扫描（CT）的作用是否可仅限于超声检查呈阳性的病例。
这项回顾性研究涵盖了2000年1月1日至2009年12月31日的10年时间，在卡拉奇阿迦汗大学医院放射科和急诊科进行。研究对象为174例出生至14岁的儿童，这些儿童因钝性腹部创伤入院并在医院接受了聚焦腹部超声检查。检查结果与腹部CT扫描及临床随访情况进行了对比。计算聚焦腹部超声检查对钝性腹部创伤的敏感性、特异性、阳性预测值、阴性预测值和准确性。使用SPSS 17进行统计分析。
在174例病例中，31例（17.81%）后来经腹部扫描确诊。在这31例儿童中，超声检查阳性的有29例（93.54%）。在31例儿童中的21例（67.74%）中，超声检查为真阳性；8例（25%）（8/31）为假阳性；2例（6%）（2/31）为假阴性。有6例（19.3%）儿童超声检查阳性并接受了剖腹手术。性别方面无显著差异（p>0.356）。本研究中聚焦腹部超声检查的敏感性为91%，特异性为95%，阳性预测值为73%，阴性预测值为73%，准确性为94%。所有超声检查阴性的患者随后均出院，临床随访期间无并发症发生。
聚焦腹部超声检查是评估儿童钝性腹部创伤的一种相当可靠的方式。它是发现高级别实质性和中空脏器损伤的有用工具。结果表明，CT扫描的作用可仅限于聚焦超声检查呈阳性的病例。
