Use of abdominal ultrasonography to assess pediatric splenic trauma. Potential pitfalls in the diagnosis.

Abstract:

OBJECTIVE:The purpose of this study was to evaluate the accuracy of abdominal ultrasonography (US) for screening and grading pediatric splenic injury. SUMMARY BACKGROUND DATA:The use of abdominal US has increased rapidly as a method of evaluating organ damage after blunt abdominal trauma. Despite US's increasing use, little is known about its accuracy in children with splenic injury. METHODS:Children (N = 32) suffering blunt abdominal trauma who were diagnosed with splenic injury by computerized tomography (CT) scan prospectively were enlisted in this study. Degree of splenic injury was evaluated by both CT and US. The ultrasounds were evaluated by an initial reading as well as by a radiologist who was blinded as to the results of the CT. RESULTS:Twelve (38%) of the 32 splenic injuries found on CT were missed completely on the initial reading of the US. When the ultrasounds were graded in a blinded fashion, 10 (31%) of the splenic lacerations were missed and 17 (53%) were downgraded. Seven (22%) of the 32 splenic fractures were not associated with any free intraperitoneal fluid on the CT scan. CONCLUSIONS:This study has shown that US has a low level of sensitivity (62% to 78%) in detecting splenic injury and downgrades the degree of injury in the majority of cases. Reliance on free intraperitoneal fluid may be inaccurate because not all patients with splenic injury have free intra-abdominal fluid. Based on these findings, US may be of limited use in the initial assessment, management, and follow-up of pediatric splenic trauma.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Krupnick AS,Teitelbaum DH,Geiger JD,Strouse PJ,Cox CS,Blane CE,Polley TZ

doi

10.1097/00000658-199704000-00010

subject

Has Abstract

pub_date

1997-04-01 00:00:00

pages

408-14

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

225

pub_type

临床试验,杂志文章
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  • Longitudinal pancreaticojejunostomy in chronic relapsing pancreatitis with onset in childhood.

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  • Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer: The POSH Observational Cohort Study.

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    doi:10.1097/SLA.0000000000001930

    authors: Maishman T,Cutress RI,Hernandez A,Gerty S,Copson ER,Durcan L,Eccles DM

    更新日期:2017-07-01 00:00:00

  • Recurrent inguinal hernia.

    abstract::An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia...

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    pub_type: 杂志文章

    doi:10.1097/00000658-198512000-00019

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    更新日期:1985-12-01 00:00:00

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    authors: Michalski CW,Shi X,Reiser C,Fachinger P,Zimmermann A,Büchler MW,Di Sebastiano P,Friess H

    更新日期:2007-11-01 00:00:00

  • The endorectal pull-through for the management of ulcerative colitis in children and adults.

    abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:

    authors: Coran AG,Sarahan TM,Dent TL,Fiddian-Green R,Wesley JR,Jordan FT

    更新日期:1983-01-01 00:00:00

  • Major hepatectomy for the treatment of complex bile duct injury.

    abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...

    journal_title:Annals of surgery

    pub_type: 杂志文章

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    authors: Laurent A,Sauvanet A,Farges O,Watrin T,Rivkine E,Belghiti J

    更新日期:2008-07-01 00:00:00

  • Gastrin release by ethanol in man and in dogs.

    abstract::In man, oral or intravenous administration of ethanol caused a small but definite increase in peripheral serum gastrin concentration (measured by radioimmunoassay). In dogs, perfusion of the antrum with 10% ethanol caused an immediate increase in gastrin levels in the antral venous outflow. Acidification of the perfus...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197406000-00015

    authors: Becker HD,Reeder DD,Thompson JC

    更新日期:1974-06-01 00:00:00

  • Impact of Weekday of Esophagectomy on Short-term and Long-term Oncological Outcomes: A Nationwide Population-based Cohort Study in the Netherlands.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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    authors: Visser E,van Rossum PSN,Verhoeven RHA,Ruurda JP,van Hillegersberg R

    更新日期:2017-07-01 00:00:00

  • One thousand liver transplants. The lessons learned.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199405000-00007

    authors: Busuttil RW,Shaked A,Millis JM,Jurim O,Colquhoun SD,Shackleton CR,Nuesse BJ,Csete M,Goldstein LI,McDiarmid SV

    更新日期:1994-05-01 00:00:00

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    更新日期:1994-03-01 00:00:00

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    pub_type: 杂志文章

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    pub_type: 杂志文章,随机对照试验

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31817ed7c3

    authors: Spillane AJ,Saw RP,Tucker M,Byth K,Thompson JF

    更新日期:2008-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198002000-00019

    authors: Li AK,Ehrlich HP,Trelstad RL,Koroly MJ,Schattenkerk ME,Malt RA

    更新日期:1980-02-01 00:00:00

  • The effect of complications on length of stay.

    abstract:OBJECTIVES:The authors determined the effect of complications on length of stay (LOS) in surgical patients. SETTING:From 1987 to 1990, in the Professional General Surgical Unit of Royal Victoria Hospital, a retrospective survey was conducted on 5128 consecutively admitted patients with 396 different diagnosis; 228 dif...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199412000-00006

    authors: McAleese P,Odling-Smee W

    更新日期:1994-12-01 00:00:00

  • Assessment of Technical Skills in Axillary Lymph Node Dissection.

    abstract:OBJECTIVE:A simulator to enable safe practice and assessment of ALND has been designed, and face, content and construct validity has been investigated. SUMMARY AND BACKGROUND DATA:The reduction in the number of ALNDs conducted has led to decreased resident exposure and confidence. METHODS:A cross-sectional multicente...

    journal_title:Annals of surgery

    pub_type: 杂志文章

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    更新日期:2020-06-24 00:00:00

  • Insulinlike growth factor-I-mediated migration and invasion of human colon carcinoma cells requires activation of c-Met and urokinase plasminogen activator receptor.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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  • Transluminal coronary angioplasty during saphenous coronary bypass surgery: a preliminary report.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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    更新日期:1980-02-01 00:00:00

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    pub_type: 杂志文章

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  • The 100 Most Cited Papers in the History of the American Surgical Association.

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    pub_type: 历史文章,杂志文章

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    pub_type: 杂志文章

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    更新日期:1983-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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    更新日期:1985-09-01 00:00:00

  • Long-term maturation of congenital diaphragmatic hernia treatment results: toward development of a severity-specific treatment algorithm.

    abstract:OBJECTIVES:To assess the impact of varying approaches to congenital diaphragmatic hernia (CDH) repair timing on survival and need for ECMO when controlled for anatomic and physiologic disease severity in a large consecutive series of patients with CDH. BACKGROUND:Our publication of 60 consecutive patients with CDH in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a53c49

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  • Sciatic and Femoral Nerve Resection During Extended Radical Surgery for Advanced Pelvic Tumours: Long-term Survival, Functional, and Quality-of-life Outcomes.

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    pub_type: 杂志文章

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