title: Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen-A Prospective Study.
abstract: Focused assessment with sonography for trauma (FAST) is a limited ultrasound examination, primarily aimed at the identification of the presence of free intraperitoneal or pericardial fluid. In the context of blunt trauma abdomen (BTA), free fluid is usually due to hemorrhage, bowel contents, or both; contributes towards the timely diagnosis of potentially life-threatening hemorrhage; and is a decision-making tool to help determine the need for further evaluation or operative intervention. Fifty patients with blunt trauma abdomen were evaluated prospectively with FAST. The findings of FAST were compared with contrast-enhanced computed tomography (CECT), laparotomy, and autopsy. Any free fluid in the abdomen was presumed to be hemoperitoneum. Sonographic findings of intra-abdominal free fluid were confirmed by CECT, laparotomy, or autopsy wherever indicated. In comparing with CECT scan, FAST had a sensitivity, specificity, and accuracy of 77.27, 100, and 79.16 %, respectively, in the detection of free fluid. When compared with surgical findings, it had a sensitivity, specificity, and accuracy of 94.44, 50, and 90 %, respectively. The sensitivity of FAST was 75 % in determining free fluid in patients who died when compared with autopsy findings. Overall sensitivity, specificity, and accuracy of FAST were 80.43, 75 and 80 %, respectively, for the detection of free fluid in the abdomen. From this study, we can safely conclude that FAST is a rapid, reliable, and feasible investigation in patients with BTA, and it can be performed easily, safely, and quickly in the emergency room with a reasonable sensitivity, specificity, and accuracy. It helps in the initial triage of patients for assessing the need for urgent surgery.
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India ; Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Virinder Kumar
authors.initials: VK
authors.lastname: Bansal
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Dillip Kumar
authors.initials: DK
authors.lastname: Muduly
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Pawan
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mahesh C
authors.initials: MC
authors.lastname: Misra
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Chumber
authors.affiliation: Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Saraman
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: D N
authors.initials: DN
authors.lastname: Bhardwaj
keywords: BTA; CECT scan; FAST; Hemoperitoneum