The hand-held ultrasound examination for penetrating abdominal trauma.
BACKGROUND
An evaluation of hand-held ultrasonography (US) in the assessment of penetrating torso trauma has not yet been reported.


METHODS
A 2.4 kg hand-held ultrasound device was used to examine penetrating trauma victims in an exam designated as the Hand-Held Focused Assessment with Sonography for Trauma (HHFAST). Results were compared with other US examinations including formal FAST (FFAST), computed tomography, diagnostic peritoneal lavage, operative and autopsy findings, and serial examination. Performance considered both the detection of fluid and injuries requiring intervention.


RESULTS
The HHFAST was excellent for detecting free intraperitoneal fluid, which had 100% specificity for peritoneal penetration, but was only moderately sensitive for injuries requiring therapy.


CONCLUSIONS
Hand-held sonography can quickly detect intraperitoneal fluid, which has good test performance in determining the presence of an intra-abdominal injury. Negative FAST examinations after penetrating trauma should be followed up with another diagnostic modality.
Kirkpatrick
Andrew W
AW
Department of Critical Care Medicine, Foothills Medical Center, Calgary, Alberta, Canada. andrew.kirkpatrick@calgaryhealthregion.ca
Sirois
Marco
M
Ball
Chad G
CG
Laupland
Kevin B
KB
Goldstein
Leanelle
L
Hameed
Morad
M
Brown
David Ross
DR
Simons
Richard K
RK
Kortbeek
John
J
Dulchavsky
Scott
S
Boulanger
Bernard B
BB
D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D010535:Laparoscopy / Q000592:standards; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000592:standards; D010808:Physical Examination / Q000592:standards; D019095:Point-of-Care Systems / Q000592:standards*; D012151:Resuscitation / Q000379:methods / Q000592:standards; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000592:standards; D014194:Traumatology / Q000379:methods / Q000592:standards; D014463:Ultrasonography; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging* / Q000601:surgery