Ultrasonography for interval assessment in the nonoperative management of hepatic trauma

Chiu, William C.; Wong-You-Cheong, Jade J.; Rodriguez, Aurelio; Shanmuganathan, K.; Mirvis, Stuart E.; Scalea, Thomas M.
October 2005
American Surgeon;Oct2005, Vol. 71 Issue 10, p841
Academic Journal
journal article
Abdominal ultrasonography (US) is gaining widespread acceptance as a valuable diagnostic tool in the initial evaluation of trauma victims. We investigated the utility of US as a follow-up radiologic study in nonoperative hepatic trauma. Patients with liver injury designated for nonoperative management were prospectively studied over a 2-year period at our primary adult resource center for trauma. Computed tomography (CT) and radiologist-performed US were obtained at admission and at 1 week. The ability of US to detect lesions, fluid, and complications was evaluated by comparing with the corresponding CT. Twenty-five hepatic trauma patients in the study were successfully managed nonoperatively and had both initial and follow-up US and CT scans: 1 (4%) grade I, 5 (20%) grade II, 7 (28%) grade III, 7 (28%) grade IV, and 5 (20%) grade V. Four complications developed [biloma (3) and biliary fistula (1)] in 3 patients with grade IV injury and 1 with a grade II injury. Interval US appropriately detected a complication or confirmed the absence of complication in all (13/13, 100%) patients with low-grade (I-III) injury and only missed a small biloma in one patient with a grade IV injury. Interval US and CT agreement was 92 per cent for change in hemoperitoneum or parenchymal lesion. Ultrasonography is a convenient imaging modality in the evaluation of hepatic trauma. US is sufficient to detect or exclude complications in low-grade injuries. In high-grade injuries, US may be an adjunct to CT for definitive interval assessment.


Related Articles

  • Paediatric anal endosonography. Jones, N. M.; Smilgin-Humphreys, M.; Sullivan, P. B.; Grant, H. W. // Pediatric Surgery International;Dec2003, Vol. 19 Issue 11, p703 

    Purpose. This study was performed to determine the endosonographic features of the anal canal in normal children and to compare these findings with the endosonographic features in children with congenital anorectal malformations. Methods. Two groups of children were examined by anal...

  • The effect of short-chain fatty acids butyrate, propionate, and acetate on urothelial cell kinetics in vitro: potential therapy in augmentation cystoplasty. Dyer, J. P.; Featherstone, J. M.; Solomon, L. Z.; Crook, T. J.; Cooper, A. J.; Malone, P. S. // Pediatric Surgery International;Jul2005, Vol. 21 Issue 7, p521 

    The intestinal element of enterocystoplasty is affected by chronic inflammatory changes, which lead to excess mucus production, urinary tract infections, and stone formation. There is also an increased risk of malignancy. These inflammatory changes may be due to diversion colitis, which affects...

  • Quality Indicators for Endoscopic Ultrasonography. Jacobson, Brian C.; Chak, Amitabh; Hoffman, Brenda; Baron, Todd H.; Cohen, Jonathan; Deal, Stephen E.; Mergener, Klaus; Petersen, Bret T.; Petrini, John L.; Safdi, Michael A.; Faigel, Douglas O.; Pike, Irving M. // American Journal of Gastroenterology;Apr2006, Vol. 101 Issue 4, p898 

    The article provides information about the quality indicators that are particular to endoscopic ultrasonography (EUS). Preprocedural indicators include the proper indications that are provided before performance of EUS. Intraprocedural indicator include the documentation of the appearance of...

  • ENDOSCOPIC VERSUS TRANSABDOMINAL ULTRASONOGRAPHY: PAST, PRESENT AND FUTURE OF ULTRASOUND IN GASTROENTEROLOGY. Jukic, Ivana; Vrebalov-Cindro, Veselin; Hozo, Izet // Acta Informatica Medica;2007, Vol. 15 Issue 1, p26 

    With more than 4 decades of experience in transabdominal ultrasonography, and more then 18 000 publications, it has become important diagnostic tool for radiologist, gastroenterologist, surgeon, internist, and family practice physician. Since its development in the 1980s, over 2000 publications...

  • Observation of Gastric Variceal Flow Characteristics by Endoscopic Ultrasonography Using Color Doppler. Takahiro Sato; Katsu Yamazaki; Jouji Toyota; Yoshiyasu Karino; Takumi Ohmura; Jun Akaike // American Journal of Gastroenterology;Mar2008, Vol. 103 Issue 3, p575 

    OBJECTIVES: The aim of this study was to investigate the endoscopic color Doppler ultrasonography (ECDUS) findings of gastric varices and to determine the role of ECDUS in the diagnosis of gastric varices. METHODS: Using ECDUS, we evaluated 114 patients with gastric varices found consecutively...

  • Pocket-Sized Ultrasound for Physical Diagnosis. Ojeda, Jason; Colbert, James; Yialamas, Maria // JGIM: Journal of General Internal Medicine;Jul2015, Vol. 30 Issue 7, p884 

    A response from the author of the article about the use of a pocket-sized ultrasound for physical diagnosis in the previous issue is presented.

  • Pocket-sized Ultrasound for Physical Diagnosis. Galen, Benjamin; Schnobrich, Daniel // JGIM: Journal of General Internal Medicine;Jul2015, Vol. 30 Issue 7, p883 

    A letter to the editor is presented in response to the article about the use of a pocket-sized ultrasound for physical diagnosis in the previous issue.

  • AkciÄŸer Kanseri Tanı ve Evrelemesindeki GeliÅŸmeler. DEMİR, Nalan; ÇİLEDAĞ, Aydın; SAVAŞ, İsmail // Turkiye Klinikleri Archives of Lung;SUP2012, Vol. 13 Issue S2, pS39 

    Lung cancer is the most common cause of deaths from cancer in all of the world. It's the most important mortality cause in men, although its frequency in women is also gradual in- creasing. Early diagnosis and treatment has been significant affected to survey, so there is needed to development...

  • Ultrasonography in loggerhead sea turtles.  // Veterinary Record: Journal of the British Veterinary Association;8/18/2007, Vol. 161 Issue 7, p216 

    The article reports on the ultrasonography used to examine young loggerhead sea turtles at the rehabilitation center in Spain by physician Ana Valente and colleagues. It is said that the group has examined 20 live turtles, using 10 areas of soft tissue integument as acoustic windows, and five...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics