Routineeinsatz von Abdomensonographie und Oberbauch-CT beim PolytraumaAnalyse der Therapierelevanz bei 105 Patienten

INTRODUCTION: A prospective analysis was done to determine the frequency of therapy relevance of abdominal computed tomography (CT) in multiple trauma patients in comparison to abdominal ultrasound (US). METHODS: We recorded all multiple trauma patients in the emergency room (n = 248) from August 1996 to July 1997 with an evaluation form and performed abdominal CT subsequent to US whenever the patient was hemodynamically stable and not in need of immediate surgery (n = 105). We documented the results of both methods and their impact on acute therapy. RESULTS: In 27 of 105 patients (25.7%) therapy management was influenced by both either US or CT. 76 patients (72.4%) showed normal US findings, followed by a CT which showed additional findings with therapeutic relevance in five patients (6.6%). Twenty-nine patients (27.6%) showed abnormal US findings. Compared to the therapeutic procedures proposed after the use of US the subsequently performed CT led to a change in therapy in 12 patients (41.4%). CONCLUSION: We conclude that if US is normal, additionally performed CT of the abdomen provides information of therapeutic relevance in only a limited number of cases. If US is abnormal, CT will have an important impact on therapy in a high number of patients.