Ultrasound potential in the diagnosis of continuing hemorrhage at combined thorax/abdomen traumas
The identifying of continuing hemorrhage is essential at choosing an adequate surgery in cases of thorax/ abdomen traumasThe purpose of the work is to develop and test non-invasive diagnosis of continuing hemorrhage in patients with a combined thorax/abdomen traumas using ultrasound visualization technology.Material and methods. 139 patients of both genders aged 37.6±13.3 with a combined thorax/abdomen traumas having visualized spare blood in cavities were examined. Their state allowed prolonging the ultrasound over the limits of FAST protocol. The ultrasound scanners Philips HDI 5000, Toshiba Aplio 500, Sonoscan S2 with multi frequency convex sensors of 3.5-5.0 МGz and multi frequency linear sensors of 7.5-12.0 МGz were used. The data of continuing hemorrhage were verified at invasive follow-up examination and surgery.Results. The suggested method of diagnosis is based on doppler graphic visualization of blood moving in a cavity of pathological liquid accumulation. The presence of colour locus in the area of the liquid accumulation is the indication of continuing hemorrhage. The size of it implicitly testifies of its intensity. In 89 out of 139 patients the hemorrhage continued at the moment of examination. The hemorrhage was observed using the developed method at ultrasound in 38 (42.7±5.2%). Including 14 (15.7±3.9%) cases with hemorrhage at pre- clinical stage that conventionally do not need surgery. The revealed hemorrhage was an indication for surgery shifting the trauma priority from thorax to abdomen and vice versa. The method was a 100.0% specific.Conclusion. The developed method is clinically beneficial as it is quick, non-invasive and maximally specific for revealing of continuing post-traumatic hemorrhage in 42,7% of patients, including 15.7±3.9% of patients at pre-clinical stage. It allows avoiding the prolonged diagnosis.