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Intervention Review

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Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma

  1. Dirk Stengel1,*,
  2. Kai Bauwens2,
  3. Grit Rademacher3,
  4. Axel Ekkernkamp4,
  5. Claas Güthoff1

Editorial Group: Cochrane Injuries Group

Published Online: 31 JUL 2013

Assessed as up-to-date: 4 FEB 2013

DOI: 10.1002/14651858.CD004446.pub3

How to Cite

Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Güthoff C. Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD004446. DOI: 10.1002/14651858.CD004446.pub3.

Author Information

  1. 1

    Unfallkrankenhaus Berlin, Centre for Clinical Research, Department of Trauma and Orthopaedic Surgery, Berlin, Germany

  2. 2

    Unfallkrankenhaus Berlin, Department of Trauma, 12683 Berlin, Germany

  3. 3

    Unfallkrankenhaus Berlin, Institute of Diagnostic & Interventional Radiology, 12683 Berlin, Germany

  4. 4

    Ernst-Moritz-Arndt University Hospital, Department of Trauma Surgery, 17487 Greifswald, Germany

*Dirk Stengel, Centre for Clinical Research, Department of Trauma and Orthopaedic Surgery, Unfallkrankenhaus Berlin, Warener Str 7, Berlin, 12683, Germany.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 31 JUL 2013


This is not the most recent version of the article. View current version (14 SEP 2015)


References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Arrillaga 1999 {published data only}
  • Arrillaga A, Graham R, York JW, Miller RS. Increased efficiency and cost-effectiveness in the evaluation of the blunt abdominal trauma patient with the use of ultrasound. The American Surgeon 1999;65:31-5.
Boulanger 1999 {published data only}
  • Boulanger BR, McLellan BA, Brenneman FD, Ochoa J, Kirkpatrick AW. Prospective evidence of the superiority of a sonography-based algorithm in the assessment of blunt abdominal injury. Journal of Trauma 1999;47:632-7.
Melniker 2006 {published data only}
  • Melniker L, Liebner E, Tiffany B, Lopez P, Quick G, Sharma M, et al. Cost analysis of point-of-care, limited ultrasonography (PLUS) in trauma patients: the sonography outcomes assessment program (SOAP)-1 trial [Abstract]. Academic Emergency Medicine 2004;11:568.
  • Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA. Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the First Sonography Outcomes Assessment Program Trial. Academic Emergency Medicine 2006;48:227-35.
Rose 2001 {published data only}
  • Hutson A. Prospective randomized trial of ED ultrasound in blunt abdominal trauma. Does it really alter abdominal CT utilization?. Society for Academic Emergency Medicine, Boston, USA. 1999.
  • Rose JS, Levitt A, Porter J, Hutson A, Greenholtz J, Nobay F, Hilty W. Does the presence of ultrasound really affect computed tomographic scan use? A prospective randomized trials of ultrasound in trauma. Journal of Trauma 2001;51:545-50.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Branney 1997 {published data only}
  • Branney SW, Moore EW, Cantrill SV, Burch JM, Terry SJ. Ultrasound based key clinical pathway reduces the use of hospital resources for the evaluation of blunt abdominal trauma. Journal of Trauma 1997;42:1086-90.
Healey 1996 {published data only}
  • Healey MA, Simons RK, Winchell RJ, Gosink BB, Casola G, Steele JT, Potenza BM, Hoyt DB. A prospective evaluation of abdominal ultrasound in blunt abdominal trauma: is it useful?. Journal of Trauma 1996;40:875-85.
Hesse 1999 {published data only}
  • Hesse S, Hörmann D, Klöppel R, Bennek J. [Einfluß der Sonographie auf die Therapieentscheidung beim sumpfen Bauchtrauma im Kindesalter]. Deutscher Röntgenkongress, Wiesbaden. 1999.
Ma 2005 {unpublished data only}
  • Ma OJ. Prospective analysis of the effect of physician experience with the FAST exam in reducing utilization of CT scans. Society for Academic Emergency Medicine, Atlanta, USA. 2001.
  • Ma OJ, Gaddis G, Steele MT, Cowan D, Kaltenbronn K. Prospective analysis of the effect of physician experience with the FAST examination in reducing the use of CT scans. Emergency Medicine Australasia 2005;17(1):24-30.
McKenney 2001 {published data only}
  • McKenney MG, McKenney KL, Hong JJ, Compton R, Cohn SM, Kirton OC, Shatz DV, Sleeman D, Byers PM, Ginzburg E, Augenstein J. Evaluating blunt abdominal trauma with sonography: a cost analysis. American Surgeon 2001;67:930-4.
Muniz 2003 {published data only (unpublished sought but not used)}
  • Muniz AE, Bartle S, Foster RL, Woleben C, Liner SR. FAST vs FAST, AST, ALT and urinanalysis in children with blunt abdominal trauma. Academic Emergency Medicine. 2003; Vol. 10:427-8.
Navarrete-Nav. 1996 {published data only}
  • Navarrete-Navarro P, Vázquez G, Bosch JM, Fernández E, Rivera R, Carazo E. Computed tomography vs clinical and multidisciplinary procedures for early evaluation of severe abdomen and chest trauma- a cost analysis approach. Intensive Care Medicine 1996;22:208-12.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Amoroso 1999
Baka 2002
  • Baka AG, Delgado CA, Simon HK. Current use and perceived utility of ultrasound for evaluation of pediatric compared with adult trauma patients. Pediatric Emergency Care 2002;18(3):163-7.
Bardenheuer 2000
  • Bardenheuer M, Obertacke U, Waydhas C, Nast-Kolb D. Epidemiology of the severely injured patient. A prospective assessment of preclinical and clinical management. AG Polytrauma of DGU [Epidemiologie des Schwerverletzten. Eine prospektive Erfassung der präklinischen und klinischen Versorgung]. Unfallchirurg. 2000; Vol. 103, issue 5:355-63.
Boulanger 2000
  • Boulanger BR, Kearney PA, Brenneman FD, Tsuei B, Ochoa J. Utilization of FAST (focused assessment with sonography for trauma) in 1999: results of a survey of North American trauma centers. The American Surgeon 2000;66(11):1049-55.
EAST 2003
  • EAST Practice Management Guidelines Work Group. Practice Management Guidelines for the evaluation of blunt abdominal trauma, 2001. Available at: Last date of access: February 27, 2003.
Emery 2001
  • Emery KH, McAneney CM, Racadio JM, Johnson ND, Evora DK, Garcia VF. Absent fluid on screening trauma ultrasonography in children: a prospective comparison with computed tomography. Journal of Pediatric Surgery 2001;38:585-9.
Hodgson 2000a
  • Hodgson NF, Stewart TC, Girotti MJ. Autopsies and death certification in deaths due to blunt trauma: what are we missing?. Canadian Journal of Surgery 2000;43(2):130-6.
Hodgson 2000b
Holm 1968
Jhirad 1998
  • Jhirad R, Boone D. Computed tomography for evaluating blunt abdominal trauma in the low-volume nondesignated trauma center: the procedure of choice?. Journal of Trauma 1998;45(1):64-8.
Jones 1983
Linsenmaier 2002
  • Linsenmaier U, Krötz M, Häuser H, Rock C, Rieger J, Bohndorf K, Pfeifer KJ, Reiser M. Whole-body computed tomography in polytrauma: techniques and management. European Radiology 2002;12(7):1728-40.
Livingston 1998
  • Livingston DH, Lavery RF, Passanante MR, Skurnick JH, Fabian TC, Fry DE, Malangoni MA. Admission or observation is not necessary after a negative computed tomographic scan in patients with suspected blunt abdominal trauma. Journal of Trauma 1998;44(2):273-82.
Miller 2003
Morrison 1996
  • Morrison JE, Wisner DH, Bodai BI. Complications after negative laparotomy for trauma: long-term follow-up in a health maintenance organization. Journal of Trauma 1996;41(3):509-13.
Nunes 2001
  • Nunes LW, Simmons S, Hallowell MJ, Kinback R, Trooskin S, Kozar R. Diagnostic performance of trauma US in identifying abdominal or pelvic free fluid and serious abdominal or pelvic injury. Academic Radiology 2001;8:128-36.
Pirente 2002
  • Pirente N, Bouillon B, Schäfer B, Raum M, Helling HJ, Berger E, Neugebauer E. Systematic development of a scale for determination of health-related quality of life in multiple trauma patients. The Polytrauma Outcome (POLO) Chart [Systematische Entwicklung eines Messinstruments zur Erfassung der gesundheitsbezogenen Lebensqualität beim polytraumatisierten Patienten: Die Polytrauma-Outcome- (POLO-)Chart]. Unfallchirurg 2002;105(5):413-22.
Prall 1994
Rademacher 2001
  • Rademacher G, Stengel D, Siegmann S, Petersein J, Mutze S. Optimization of contrast agent volume for helical CT in the diagnostic assessment of patients with severe and multiple injuries. Journal of Computer Assisted Tomography 2001;26(1):113-8.
Ruchholtz 2002
  • Ruchholtz S, Waydhas C, Schroeder T, Piepenbrink K, Kuhl H, Nast-Kolb D. The value of computed tomography in the early treatment of seriously injured patients [Stellenwert der Computertomographie in der frühen klinischen Behandlung schwer verletzter Patienten]. Chirurgie 2002;73(10):1005-12.
Scalea 1999
  • Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon WF, Kato K, McKenney MG, Nerlich ML, Ochsner MG, Yoshii H. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. Journal of Trauma 1999;46(3):466-72.
Scheck 1998
  • Scheck RJ, Coppenrath EM, Kellner MW, Lehmann KJ, Rock C, Rieger J, Rothmeier L, Schweden F, Bauml AA, Hahn K. Radiation dose and image quality in spiral computed tomography: multicentre evaluation at six institutions. British Journal of Radiology 1998;71(847):734-44.
Stalp 2002
  • Stalp M, Koch C, Ruchholtz S, Regel G, Panzica M, Krettek C, Pape HC. Standardized outcome evaluation after blunt multiple injuries by scoring systems: a clinical follow-up investigation 2 years after injury. Journal of Trauma 2002;52(6):1160-8.
Stengel 2001
Stengel 2003
  • Stengel D, Bauwens K, Porzsolt F, Rademacher G, Mutze S, Ekkernkamp A. Emergency ultrasonography for blunt abdominal trauma. Meta-analysis update 2003 [Sonografische Diagnostik im Schockraum bei stumpfem Bauchtrauma. Meta-Analyse Update 2003]. Zentralbl Chirugerie 2003;128:1027-37.
Sydney report 2003
  • South Western Sydney Regional Trauma Registry Report 1995 -1999. Available at: Last date of access: February 27, 2003.
Vance 2007
  • Vance S. Evidence-based emergency medicine/systematic review abstract. The FAST scan: are we improving care of the trauma patient?. Annals of Emergency Medicine 2007;49:364-6.
Wintermark 2002
  • Wintermark M, Poletti PA, Becker CD, Schnyder P. Traumatic injuries: organization and ergonomics of imaging in the emergency environment. European Radiology 2002;44(5):273-82.
Yoshii 1998
  • Yoshii H, Sato M, Yamamoto S, Motegi M, Okusawa S, Kitano M, Nagashima A, Doi M, Takuma K, Kato K, Aikawa N. Usefulness and limitations of ultrasonography in the initial evaluation of blunt abdominal trauma. Journal of Trauma 1998;45(1):45-50.