Role of FAST or Abdominal Ultrasound to Limit CT Imaging in Evaluation of the Pediatric Abdominal Trauma Patient

Abstract

Blunt abdominal trauma (BAT) can produce serious intra-abdominal injuries (IAI) in children. An early diagnosis is important to reduce morbidity and mortality, but pediatric patients sustaining BAT rarely require an operative intervention. Although the computed tomography (CT) scan is currently the best diagnostic tool to detect IAI, increased awareness of the risks of radiation exposure, high costs, and low utility has led to efforts to reduce the use of CT in the workup of pediatric trauma patients. Focused assessment with sonography for trauma (FAST) is an accurate, noninvasive, and rapid method of evaluating patients with BAT. Many institutions have developed criteria using physical signs and common biochemical markers of abdominal injury in combination with FAST as a screening tool to prevent the overuse of CT in children. We review the use of FAST and scoring systems as tools to limit CT imaging in the evaluation of the pediatric abdominal trauma patient.