Role of ultrasonography in blunt abdominal trauma

Abstract

Objective The aim of the study was to assess the role of ultrasonography (US) focused assessment with sonography in trauma (FAST) at the time of presentation and ultrasound repeated after 12–24 h in early diagnosis of intra-abdominal injury (IAI) following blunt abdominal trauma (BAT) and for follow-up. Background US was used in patients with IAI. Trauma is the most common cause of mortality. The most common mechanisms resulting in BAT among patients were motor vehicle collisions (73%), motorcycle collisions (7%), auto–pedestrian collisions (6%), and falls (6%). Patients and methods This is a prospective study of 50 patients presented to the Emergency Room of Menoufia University Hospital with BAT who underwent US and FAST examination at the time of presentation and were followed up with US after 12–24 h. Of them, 12 patients were hemodynamically unstable, six patients had severe intra-abdominal hemorrhage and entered the operation theater urgently after FAST examination, and the other six patients entered the ICU for urgent care, FAST findings, and follow-up. US findings were correlated with patients' clinical data. Results US is very useful in the follow-up of patients with minor IAI and it decreases the use of computed tomography. However, ultrasound is operator dependent and could overlook lacerations of solid organs and gastrointestinal injuries. Therefore, contrast-enhanced computed tomography is still considered the gold standard in the evaluation of the exact site and the degree of IAI. Conclusion We concluded that ultrasound is considered the best modality in the initial evaluation of patients with BAT. However, repeated ultrasound in patients of BAT increases the sensitivity of ultrasound for causing intra-abdominal bleeding to 100%.