Findings and limitations of focused ultrasound as a possible screening test in stable adult patients with blunt abdominal trauma: a Greek study

• Published in: European radiology 2010, Vol.20 (1), p.234-238
• Main Authors: Kornezos, Ioannis, Chatziioannou, Achilles, Kokkonouzis, Ioannis, Nebotakis, Panagiotis, Moschouris, Hippocrates, Yiarmenitis, Spiridon, Mourikis, Dimitrios, Matsaidonis, Dimitrios
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Injuries - diagnostic imaging; Abdominal Injuries - epidemiology; Adult; Assaults; Bladder; Catheters; Diagnostic Radiology; Emergency medical care; Feasibility Studies; Female; Greece - epidemiology; Hospitals; Humans; Imaging; Incidence; Internal Medicine; Interventional Radiology; Kidneys; Laparotomy; Liver; Male; Mass Screening - statistics & numerical data; Medicine; Medicine & Public Health; Neuroradiology; Pancreas; Patients; Radiology; Reproducibility of Results; Risk Assessment - methods; Risk Factors; Sensitivity and Specificity; Spleen; Trauma; Ultrasonic imaging; Ultrasonography - statistics & numerical data; Ultrasound; Wounds, Nonpenetrating - diagnostic imaging; Wounds, Nonpenetrating - epidemiology
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-009-1516-1

Our objective is to underline the place of FAST (focus assessment by sonography for trauma) ultrasonography (US) in the investigation of blunt abdominal trauma. We retrospectively examined the ultrasound findings in 1,999 haemodynamically stable adult patients. These people were admitted to the emergency room (ER) for possible blunt abdominal trauma. All were stable at admission and a FAST ultrasound examination was made. Initial findings were compared with the clinical course after at least 24 h of observation time and CT results. Among the 1,999 US examinations, abnormalities were found in 109 (5.5%) cases. Among them, 102 had free peritoneal fluid, and in 58 examinations, ruptures, lacerations or haematomas were demonstrated. Despite its limitations, such as in cases involving uncooperative patients, excessive bowel gas, obesity and empty bladder, the FAST technique seems to be an accurate method to evaluate the possibility of abdominal blunt trauma in stable patients. Because of the high negative predictive value of the FAST technique in stable patients with blunt abdominal trauma, we recommend that a stable patient with negative ultrasound results at admission remain under close observation for at least 12 or preferably 24 h before being discharged.