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Hypotensive Patients with Blunt Abdominal Trauma: Performance of Screening US¹

¹ From the Departments of Radiology (N.F., C.B.S., M.A.B., G.C.) and Surgery (D.F., D.B.H.) and General Clinical Research Center (G.P.S.), University of California at San Diego, 200 W Arbor Dr, San Diego, CA 92103-8756. From the 2001 RSNA Annual Meeting. Received March 31, 2004; revision requested June 8; revision received June 18; accepted July 27. Supported in part by a 2003 scholarship from the American Roentgen Ray Society; National Institutes of Health (NIH) grant 1K08 CA 102158; and NIH grant MO1-RR00827 from the National Center for Research Resources of the NIH for the University of California at San Diego, General Clinical Research Center. Address correspondence to C.B.S. (e-mail: csirlin@ucsd.edu).

View larger version (26K): [in a new window]   Proposed algorithm for screening patients with blunt abdominal trauma. Hemodynamically unstable patients are initially screened with US. If US findings are positive and the patient can be stabilized, CT can be performed. If US findings are positive and the patient cannot be stabilized, exploratory laparotomy should be performed emergently. Hemodynamically stable patients with known or suspected hematuria and/or axial fracture should undergo CT directly, unless other clinical findings or logistical considerations mandate initial US. Patients with no known or suspected injury predictors can undergo screening US first. BAT = blunt abdominal trauma, OR = transport to operating room (eg, for exploratory laparotomy), IR = transport to interventional radiology (eg, for transarterial embolization).