McKenney et al developed an ultrasound score (USS) to describe the accumulation of intra-abdominal fluid in the trauma patient. This can help identify a patient who may require a laparotomy.
Areas examined by ultrasound:
(1) Morison's pouch (below the liver and to the lateral to the right kidney)
(2) perisplenic area
(3) left subphrenic space
(4) right subphrenic space
(5) pelvis
Parameters:
(1) depth of the fluid in each pocket in cm
(2) number of pockets with fluid
Parameter
Points
depth of fluid in each pocket
MAX(depth for pockets with fluid)
number of pockets with fluid
MAX(0, - 1)
USS =
= (points for fluid depth) + (points for number of pockets with fluid)
Interpretation:
• minimum score: 0
• maximum score: 9 or more
• Ong et al found that a USS > 3 indicated the need for laparotomy in pediatric trauma patients.
Performance:
• For pediatric patients, Ong et al showed a sensitivity of 89% and specificity of 75% for the patient needing laparotomy.
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