Identification of Hollow Viscus Injury with FAST Examination in Kurdistan, Iraq.

Ruj Al-Sindy,Mahmood Sh Hafdullah,Christine Butts,Heleen Alaqrawy

doi:10.1155/2018/5019415

Abstract

Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury. We present a case of an unidentified man that presented to a hospital in the Kurdistan region of northern Iraq, a region of low resources, surrounded by war. The FAST exam proved to be the key to identifying this patient's injuries.

Highlights

Hollow viscus injuries resulting from blunt abdominal trauma (BAT) are rare, they convey a high morbidity and mortality
The FAST examination (Focused Assessment with Sonography in Trauma) has been extensively studied as a tool in the evaluation of free fluid resulting from solid organ injury, but less so for the more subtle findings of hollow viscus injury
We present a case from Kurdistan, Iraq, in which a bedside FAST examination identified a suspected and later confirmed case of ruptured viscus

Summary

Background

Hollow viscus injuries resulting from blunt abdominal trauma (BAT) are rare, they convey a high morbidity and mortality. Diagnosing these injuries remains challenging, despite advances in imaging. The FAST examination (Focused Assessment with Sonography in Trauma) has been extensively studied as a tool in the evaluation of free fluid resulting from solid organ injury, but less so for the more subtle findings of hollow viscus injury. FAST examination may be the only immediately available imaging modality in low resource environments, and the determination of characteristics that could rapidly identify findings of viscus injury could prove invaluable. We present a case from Kurdistan, Iraq, in which a bedside FAST examination identified a suspected and later confirmed case of ruptured viscus

Case Report

Findings

Discussion