Role of Focused Abdominal Sonography for Trauma in Solid Organ Injury in Paediatric Blunt Abdominal Trauma

Abstract

BACKGROUND The term Focused Assessment with Sonography for Trauma (FAST) was coined by Rozycki et al in 1996. It is now termed "focused abdominal sonography for trauma". It is an emergency ultrasound scan done in abdominal trauma with focus on four quadrants of abdomen-right upper quadrant, left upper quadrant, subxiphoid region and pelvis. It is a good rapid [only 2 to 3 minutes] screening tool to guide surgeon regarding management of blunt abdominal trauma cases. MATERIALS AND METHODS This is descriptive study 66 patients [age range 3-12 years, with blunt trauma abdomen were subjected to a thorough clinical history, clinical examination and FAST Examination and in many cases compared with CT scan and operative findings. RESULTS Of 66 paediatric blunt abdominal trauma patients, 48 were male and 18 were female. FAST was done in 65 cases. In 49 cases, free fluid was detected whereas; in 16 cases no free fluid was detected. 46 cases were true positive, 15 were true negative. 3 false positive and 1 false negative. The sensitivity, specificity and accuracy of FAST were 93.7%, 94% and 90.6% respectively. There were 46 cases of abdominal visceral injury, of which 14 were bowel injuries, 32 solid abdominal organ injuries, mostly isolated and 11 had multiple organ injuries. FAST detected free fluid in all 32 cases of abdominal solid organ injuries. 57 cases were stable and only 9 were hemodynamically unstable.