Computed tomography in the evaluation of blunt abdominal trauma

1989 ◽  
Vol 18 (4) ◽  
pp. 481
Author(s):  
WC Pevec ◽  
AB Peitzman ◽  
AO Udekwu ◽  
W Straub
Author(s):  
Sameer Ahmed

Background: The initial evaluation of patient with multiple trauma is a challenging task. FAST (focussed assessment with sonography in trauma) provides a viable alternative to computed tomography in blunt abdominal trauma patient. The aim of this study was to find the accuracy and utility of FAST in clinical decision making, as well as limitations.Methods: A total of 100 patients with blunt abdominal trauma who underwent FAST examination were included. Positive scan was defined as the presence of free intraperitoneal fluid. The sonographic scoring for operating room triage in trauma (SSORTT Score) was calculated using cumulative sum of ultrasound score, systolic blood pressure, and pulse rate. FAST findings were compared with computed tomography findings and in operated cases compared with surgical findings & clinical outcome.Results: We determined SSORTT score in all 100 cases. In our study, the sensitivity, specificity, positive and negative predictive values for FAST in identifying intraabdominal injuries were 93.9%, 94.2%, 87.5%, and 97.2%. In our study we found out that patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy.Conclusions: In our study we found that FAST is a rapid, reproducible, portable and non-invasive bedside test, and can be performed at the same time as resuscitation. Ultrasound is limited mainly by its low sensitivity in directly demonstrating solid organs injuries.


Injury ◽  
2010 ◽  
Vol 41 (5) ◽  
pp. 475-478 ◽  
Author(s):  
Ker-Kan Tan ◽  
Jody Zhiyang Liu ◽  
Tsung-Shyen Go ◽  
Appasamy Vijayan ◽  
Ming-Terk Chiu

2014 ◽  
Vol 21 (6) ◽  
pp. 396-399 ◽  
Author(s):  
Pk Tsai ◽  
Yt Yeh ◽  
Cb Yeh

Most emergency department (ED) physicians implement the Advanced Trauma Life Support (ATLS) approach, including primary and secondary survey, for the assessment of blunt abdominal trauma (BAT) patients. This report emphasizes the need for repeat Focused Assessment with Sonography for Trauma (FAST) and abdominal computed tomography (CT) if a BAT patient's condition persists or worsens. After initial negative FAST and abdominal CT findings, it is recommended that BAT patients with suspected intraabdominal injury should receive repeat examination in an optimal time. We report a patient who sustained duodenal perforation following BAT diagnosed by repeat ultrasound examination and abdominal CT scan. (Hong Kong j.emerg.med. 2014;21:396-399)


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