Hemoperitoneum: Likelihood Ratios

Introduction: aka intraperitoneal hemorrhage

Prevalence

Patients presenting with blunt abdominal trauma

for injuries requiring laparotomy (not just bleeding)

Emerg Med Clin North Am. 1999 Feb;17(1):63-75, viii. PMID: 10101341

The likelihood ratios of findings for Hemoperitoneum are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)


Finding	Result	+LR	-LR
[ + ] Abdominal CT	+ 0 -	inf	0
Various studies have shown sens, spec all >92%. These particular numbers are from a large retrospective analysis. Note that oral contrast is unnecessary. Study: Emerg Med Clin North Am. 1999 Feb;17(1):63-75, viii. PMID: 10101341
[ + ] Abdominal US	+ 0 -	20.3	0.2
i.e. FAST. Note that US can only detect hemoperitoneum, not isolated damage to abdominal organs. Study: Emerg Med Clin North Am. 1999 Feb;17(1):63-75, viii. PMID: 10101341
[ + ] Diagnostic Peritoneal Lavage	+ 0 -	23.5	0.1
These studies evaluated for presence of any abdominal injury and were done in days when many more of these went to surgery than is currently done. Some series noted up to a 5% complication rate. from Gavi: Positive results are considered: 10 ml of gross blood, enteric content aspirate, RBC count >100,000/mL, or a WBC count of > 500/mL Study: Emerg Med Clin North Am. 1999 Feb;17(1):63-75, viii. PMID: 10101341