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. 2012 Jan 20;7(1):2.
doi: 10.1186/1749-7922-7-2.

Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": the role of repeated ultrasonography

Afshin Mohammadi  1 , Mohammad Ghasemi-Rad
Affiliations

Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": the role of repeated ultrasonography

Afshin Mohammadi et al. World J Emerg Surg. .

Abstract

Background: To determine the diagnostic Accuracy of Focused Assessment Sonography for Trauma (FAST) and repeated FAST in the patients with blunt abdominal trauma.

Methods: In this retrospective study we collected the data of all patients from September 2007 to July 2011 with gastrointestinal injury. The intraoperative outcome was compared with FAST technique and the repeated or delayed sonography.

Results: A total number of 1550 patients with blunt abdominal trauma underwent FAST in a period of 4 years in our hospital. Eighty-eight (5.67%) patients were found to have gastrointestinal injury after exploratory laparotomy. Fifty-five (62.5%) patients had isolated gastrointestinal injury and 33 (37.5%) patients had concomitant injury to the other solid organs. In those with isolated gastrointestinal injury, the sensitivity of FAST was 38.5%. Repeated ultrsonography was performed in 34 patients with false negative initial FAST after 12-24 hours. The sensitivity of repeated ultrasonography in negative initial FAST patients in detection of gastrointestinal injury was 85.2% (95% CI, 68.1%, and 94.4%).

Conclusion: Repeated sonography after 12 to 24 hours in patients with negative initial FAST but sustain abdominal symptom can facilitated a diagnosis of GI tract injury and can be as effective method instead of Computed tomography in developing country.

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Figures

Figure 1
Figure 1
Longitudinal sonogram show free fluid (arrow) associated with Ileal perforation in pelvic cavity.
Figure 2
Figure 2
Ultrasonogram revealed free fluid in the paracolic gutter (right) and perisplenic (left).
Figure 3
Figure 3
Abdominal CT scan with lung window shows free air adjacent to liver edge due to colon perforation.
See this image and copyright information in PMC

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