Initial Fast Scan Finding in Hemodynamically Stable Patient with Blunt Abdominal Trauma

Abstract

Background and objectives: Abdominal trauma can cause severe injuries to various internal organs. Focused assessment with sonography for trauma is an ultrasound technique for free intraperitoneal fluid detection in blunt abdominal trauma patients. This study aimed to investigate the importance of FAST scan as an initial imaging modality and early detection of free fluid in hemodynamically stable blunt abdominal trauma patients presenting to the emergency department. Methods: This was a prospective cross-sectional study conducted in the emergency department of Shar Hospital, Sulaymaniyah, Iraq, from April 2022 to March 2023. The study involved 103 hemodynamically stable patients presented with blunt abdominal trauma. Patient demographics, vital signs, symptoms, and FAST results were recorded and analyzed. Results: The study included 71 males and 32 females, with a mean age of 31.64 ± 15.04 years. Vehicle collisions accounted for 65% of the cases. Abdominal pain was the most common symptom (68%). Only seven patients (6.8%) had a positive FAST test; free fluid was found around the liver, renal, and in pelvic regions. A positive FAST was significantly associated with blunt trauma to the abdomen (p = 0.001) and related to the site of injury (p < 0.001). Patients with positive FAST had higher heart rates (p=0.005) and shorter time of injury before arrival to the hospital (p=0.002) than those with negative FAST. Conclusions: In hemodynamically stable patients with blunt abdominal trauma, initial FAST detected free peritoneal fluid in a small percentage of cases. Patients with a positive FAST presented earlier and had higher heart rates.

Keywords

• blunt abdominal trauma
• diagnostic accuracy
• focused assessment with sonography for trauma (fast)
• free fluid