Schneck Emmanuel, Koch Christian, Borgards Mara, Reichert Martin, Hecker Andreas, Heiß Christian, Padberg Winfried, Alejandre-Lafont Enrique, Röhrig Rainer, Krombach Gabriele Anja, Weigand Markus, Bernhard Michael, Roller Fritz Christian
Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.
Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany.
Rofo. 2017 Feb;189(2):128-136. doi: 10.1055/s-0042-120844. Epub 2017 Jan 31.
Patients suffering from severe blunt abdominal trauma are challenging because of their need for accurate diagnostic imaging and fast therapeutic action. Whole-body computed tomography (WBCT) is highly sensitive and represents the gold standard in the trauma room diagnostic setting. The aim of our study was to investigate the impact and therapy relevance of abdominal follow-up sonography (AFS) as part of the tertiary trauma survey (TTS) in patients without abdominal parenchymal organ lesions or free abdominal fluid in initial WBCT. All adult patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination, who received AFS within 24 hours after trauma, were included in this retrospective analysis between January 2008 and December 2011. 316 patients were analyzed (ISS 10 ± 8, NISS 13 ± 11) according to the inclusion criteria. Overall, only small amounts of free intraabdominal fluid were detected in AFS in 3 patients (0.9 %) and remained without therapeutic consequence. None of the patients died due to intraabdominal bleeding. AFS as part of the TTS did not show additional benefits and had no impact on further treatment in patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination. We conclude that AFS is not routinely required but should be performed if indicated on a clinical or laboratory basis because of its fast and less invasive character. · Seriously injured patients are challenging for medical imaging and treatment.. · Whole-body computed tomography is known for its high accuracy in trauma patients.. · Nonetheless, missed injuries are a major challenge in trauma patients.. · Therefore, follow-up ultrasound is often performed within the tertiary trauma survey.. · Follow-up ultrasound in patients with an inconspicuous abdominal computed tomography scan did not show any benefit.. · Schneck E, Koch C, Borgards M et al. Impact of Abdominal Follow-Up Sonography in Trauma Patients Without Abdominal Parenchymal Organ Lesion or Free Intraabdominal Fluid in Whole-Body Computed Tomography. Fortschr Röntgenstr 2017; 189: 128 - 136.
患有严重钝性腹部创伤的患者具有挑战性，因为他们需要准确的诊断成像和快速的治疗措施。全身计算机断层扫描（WBCT）具有高度敏感性，是创伤室诊断中的金标准。我们研究的目的是调查腹部随访超声检查（AFS）作为三级创伤检查（TTS）一部分，在初始WBCT检查中无腹部实质器官损伤或腹腔内游离液体的患者中的影响及治疗相关性。2008年1月至2011年12月期间，对所有在初始WBCT检查中无腹部实质器官损伤或腹腔内游离液体、且在创伤后24小时内接受AFS检查的成年患者进行了这项回顾性分析。根据纳入标准分析了316例患者（损伤严重度评分[ISS]为10±8，新损伤严重度评分[NISS]为13±11）。总体而言，AFS仅在3例患者（0.9%）中检测到少量腹腔内游离液体，且未产生治疗后果。没有患者因腹腔内出血死亡。在初始WBCT检查中无腹部实质器官损伤或腹腔内游离液体的患者中，作为TTS一部分的AFS未显示出额外益处，对进一步治疗也没有影响。我们得出结论，AFS并非常规必需，但由于其快速且侵入性较小的特点，如果基于临床或实验室指征则应进行检查。·重伤患者在医学成像和治疗方面具有挑战性。·全身计算机断层扫描以其在创伤患者中的高准确性而闻名。·尽管如此，漏诊损伤仍是创伤患者面临的重大挑战。·因此，在三级创伤检查中经常进行随访超声检查。·腹部计算机断层扫描扫描无异常的患者进行随访超声检查未显示任何益处。·施内克E、科赫C、博尔加兹M等。全身计算机断层扫描中无腹部实质器官损伤或腹腔内游离液体的创伤患者腹部随访超声检查的影响。《德国放射学杂志》2017年；189:128 - 136。
