EVALUATING THE DIAGNOSTIC VALUE OF ULTRASONOGRAPHY IN DETECTING INTRAPERITONEAL FREE AIR (IPFA) IN EMERGENCY AND TRAUMA SETTINGS
To consider the use of ultrasound as a diagnostic tool of the intraperitoneal free air (IPFA) that can be considered useful during the treatment process and administration of emergencies and traumas. The preset study was conducted at Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry. Patients who were exposed to severe blunt trauma, with chest, abdomen, pelvis injuries and the ones who had no such injuries, but severe acute pain in the abdomen (n=484) were queried by US to reveal IPFA. The patients who were excluded were those with hemorrhagic shock and large volume of intraperitoneal fluid, penetrating or open abdominal injury, patients who transferred to the center when general surgeons were not available. The primary measure was the sensitivity and specificity of US in diagnosis of gastrointestinal perforation as determined by gastroenterologists or general surgeons familiar with the use of US with an experience of more than 5 years. Presence of high-echoic areas in the ventral space of liver indicated the creation of a diagnosis of IPFA by US. The diagnosis was concluded by an operative diagnosis or a radiological and clinical diagnosis of the gastrointestinal perforation more than four days. Fifty-four patients experienced gastrointestinal perforation. The US sensitivity in the diagnosis of gastrointestinal perforation was 85.7% in patients with blunt trauma in the abdomen with a specificity of 99.6%. This was displayed by sensitivity of 85.0 percent and specificity of 100 percent when applied to patients with severe acute abdominal pain. Ultrasonography has been thought to be useful in diagnostics of the acute abdominal pain or blunt trauma patients in whose case it is IPFA with absent gastrointestinal perforation