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Tertiary survey ultrasound has no diagnostic benefit in trauma patients without abdominal injuries on standardised initial whole-body computed tomography

Published:September 27, 2021DOI:https://doi.org/10.1016/j.ejrad.2021.109977

      Highlights

      • Six patients presented new findings in their tertiary survey US compared to WBCT.
      • No patient with new findings on US died or underwent surgery/intervention.
      • Routine tertiary survey US can be omitted in patients without abdominal injury.

      Abstract

      Purpose

      The aim of our study was to evaluate the impact of a routine tertiary survey ultrasound (US) on patient management in major trauma patients without trauma-related abdominal findings on standardised initial whole-body CT (WBCT).

      Methods

      In this retrospective study, all WBCT scans acquired in major trauma patients between 07/2017 and 12/2019 at a university hospital and level I trauma centre were screened. 1,024 patients were included in the final analysis. Results of tertiary survey US and patient information (demographic data, trauma mechanism, imaging findings, clinical course, medical history, and anticoagulative medication) were collected and analysed.

      Results

      Routine tertiary survey US revealed new abdominal findings in six out of 1,024 patients (0.6%). None of the patients had to undergo surgery or minimally invasive intervention, nor did any of the patients die as a result of abdominal injuries. Additional abdominal imaging after tertiary survey US was ordered in 39 patients (38 US, 1 US + CT). None of these patients required further treatment for abdominal injuries.

      Conclusions

      Routine tertiary survey US after inconspicuous standardised initial WBCT did not change clinical outcome for abdominal trauma patients.

      Keywords

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