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Concept Paper

The “Black Pattern”, a Simplified Ultrasound Approach to Non-Traumatic Abdominal Emergencies

by
Stefania Tamburrini
1,2,*,
Letizia Consoli
3,4,
Marco Garrone
5,6,
Giuseppe Sfuncia
7,
Marina Lugarà
2,8,
Maria Gabriella Coppola
2,8,
Miryam Piccirillo
2,9,
Roberta Toto
2,9,
Salvatore Massimo Stella
10,11,
Soccorsa Sofia
12,13,
Mario Scuderi
14,15 and
Orlando Catalano
2,16
1
Department of Radiology, Ospedale del Mare-Asl NA1 Centro, Via Enrico Russo, 11, 80147 Napoli, Italy
2
Advanced Emergency Ultrasound SIUMB School, 80147 Naples, Italy
3
Department of Emergency Medicine, Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy
4
Advanced Emergency Ultrasound SIUMB School, 25124 Brescia, Italy
5
Department of Emergency Medicine, A.O. Mauriziano, Largo Filippo Turati, 62, 10128 Torino, Italy
6
Advanced Emergency Ultrasound SIUMB School, 10128 Torino, Italy
7
Department of Emergency Medicine, Ospedale santi Giovanni e Paolo, Sestriere Castello, 6777, 30122 Venezia, Italy
8
Department of Internal Medicine, Ospedale del Mare-Asl NA1 Centro, Via Enrico Russo, 11, 80147 Napoli, Italy
9
Department of Anesthesiology and Intensive Care, Ospedale del Mare-Asl NA1 Centro, Via Enrico Russo, 11, 80147 Napoli, Italy
10
Department of Clinical and Experimental Medicine, University of Pisa, Santa Chiara University Hospital, Via Roma, 67, 56100 Pisa, Italy
11
Advanced Emergency Ultrasound SIUMB School, 56100 Pisa, Italy
12
Department of Emergency Medicine, Ospedale Maggiore-C. A. Pizzardi, Largo Nigrisoli, 2, 40133 Bologna, Italy
13
Advanced Emergency Ultrasound SIUMB School, 40133 Bologna, Italy
14
Policlinico Morgagni, Via del Bosco, 105, 95125 Catania, Italy
15
Advanced Emergency Ultrasound SIUMB School, 95125 Catania, Italy
16
Istituto Diagnostico Varelli, Via Cornelia dei Gracchi, 65, 80126 Naples, Italy
 
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Author to whom correspondence should be addressed.
Tomography 2022, 8(2), 798-814; https://doi.org/10.3390/tomography8020066
Submission received: 31 January 2022 / Revised: 9 March 2022 / Accepted: 11 March 2022 / Published: 15 March 2022
(This article belongs to the Special Issue Imaging in Non-Traumatic Emergencies)
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Abstract

Background: A key issue in abdominal US is the assessment of fluid, which is usually anechoic, thus appearing “black”. Our approach focuses on searching for fluid in non-traumatic patients, providing a new, simplified method for point-of-care US (POCUS). Objective: Fluid assessment is based on a three-step analysis that we can thus summarize. 1. Look for black where it should not be. This means searching for effusions or collections. 2. Check if black is too much. This means evaluating anatomical landmarks where fluid should normally be present but may be abnormally abundant. 3. Look for black that is not clearly black. This means evaluating fluid aspects, whether wholly anechoic or not (suggesting heterogeneous or corpusculated fluid). Discussion: Using this simple method focused on US fluid presence and appearance should help clinicians to make a timely diagnosis. Although our simplified, systematic algorithm of POCUS may identify abnormalities; this usually entails a second-level imaging. An accurate knowledge of the physio–pathological and anatomical ultrasound bases remains essential in applying this algorithm. Conclusion: The black pattern approach in non -traumatic emergencies may be applied to a broad spectrum of abnormalities. It may represent a valuable aid for emergency physicians, especially if inexperienced, involved in a variety of non-traumatic scenarios. It may also be a simple and effective teaching aid for US beginners.
Keywords: emergency ultrasound; abdominal ultrasound; ultrasound; abdomen; emergency emergency ultrasound; abdominal ultrasound; ultrasound; abdomen; emergency

Share and Cite

MDPI and ACS Style

Tamburrini, S.; Consoli, L.; Garrone, M.; Sfuncia, G.; Lugarà, M.; Coppola, M.G.; Piccirillo, M.; Toto, R.; Stella, S.M.; Sofia, S.; et al. The “Black Pattern”, a Simplified Ultrasound Approach to Non-Traumatic Abdominal Emergencies. Tomography 2022, 8, 798-814. https://doi.org/10.3390/tomography8020066

AMA Style

Tamburrini S, Consoli L, Garrone M, Sfuncia G, Lugarà M, Coppola MG, Piccirillo M, Toto R, Stella SM, Sofia S, et al. The “Black Pattern”, a Simplified Ultrasound Approach to Non-Traumatic Abdominal Emergencies. Tomography. 2022; 8(2):798-814. https://doi.org/10.3390/tomography8020066

Chicago/Turabian Style

Tamburrini, Stefania, Letizia Consoli, Marco Garrone, Giuseppe Sfuncia, Marina Lugarà, Maria Gabriella Coppola, Miryam Piccirillo, Roberta Toto, Salvatore Massimo Stella, Soccorsa Sofia, and et al. 2022. "The “Black Pattern”, a Simplified Ultrasound Approach to Non-Traumatic Abdominal Emergencies" Tomography 8, no. 2: 798-814. https://doi.org/10.3390/tomography8020066

APA Style

Tamburrini, S., Consoli, L., Garrone, M., Sfuncia, G., Lugarà, M., Coppola, M. G., Piccirillo, M., Toto, R., Stella, S. M., Sofia, S., Scuderi, M., & Catalano, O. (2022). The “Black Pattern”, a Simplified Ultrasound Approach to Non-Traumatic Abdominal Emergencies. Tomography, 8(2), 798-814. https://doi.org/10.3390/tomography8020066

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