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Volume 28, Issue 146, April 2024

Assessment of blunt abdominal trauma in the emergency department: Systematic review

Mazi Mohammed Alanazi¹, Muayad Mohammed Abdullah Algrairy², Alaa Abdullah Alghamdi², Tamim Khalid Abdullah Abdulrahim³

¹Senior Registrar Emergency Medicine, Emergency Department, First Health Cluster, Riyadh, Saudi Arabia
²Saudi Board Emergency Medicine Resident, Second Health Cluster, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
³Medical Intern, College of Medicine, Bisha University, Bisha, Saudi Arabia

ABSTRACT

Background: When evaluating blunt abdominal trauma patients initially, it is important to do an extended assessment using with solography exam. This study aimed to conduct a comprehensive analysis of the current literature concerning the diagnostic accuracy of all aspects of trauma assessment utilizing solography examination. Method: A comprehensive review of the literature about emergency department studies examining the diagnostic efficacy of contrast enhanced and conventional ultrasonography performed before CT imaging for abdominal injuries was carried out across large databases. The PRISMA statement was adhered to by the study. The research included in the literature search were released between 2007 and 2023. Result: The organ that was examined the most was the liver, while the organ that was investigated the least was the pancreas. Of the included studies three showed a variety of abdominal injury types, including the presence of free abdominal fluid, continuous bleeding, and solid organ damage signs. CEUS is more accurate than baseline US and almost as sensitive as CT. CT is more precise and sensitive than contrast enhanced US in identifying prognostic indicators such urinoma and current bleeding. Contrast enhanced US should be considered in the evaluation and follow-up of children who have experienced traumatic abdominal injuries. Conclusion: When utilised as the initial examination in the emergency room, CEUS had a higher diagnostic value than conventional ultrasound for discriminating blunt abdominal trauma.

Keywords: Blunt abdominal trauma, assessment, emergency department, ultrasonography