Role of fast and DPL in assessment of blunt abdominal trauma

ABSTRACT

To assess and compare the diagnostic accuracy of Diagnostic Peritoneal Lavage [DPL] and Focused Assessment Sonography for Trauma [FAST]. A comparative study. SU II Department of surgery Allied Hospital Faisalabad. From Jan 2006 to Dec 2006 A total of 50 patients irrespective of age and sex, presenting to casualty department with blunt trauma abdomen were included in the study. Patients with equivocal signs of peritonitis under went abdominal ultra sonography followed by diagnostic peritoneal lavage. The operative findings were also recorded. Out of total 50 patients, Sensitivity of FAST was 88.88%, Specificity 91.30%, Accuracy 90.00%, and Positive predictive value 92.30%, Negative predictive value 91.30%. In 3 patients ruled out on ultra sonography but confirmed on Diagnostic peritoneal lavage and exploratory laparotomy [false negative]. Sensitivity of DPL was 96.66%, Specificity 85.00%. Accuracy 92.00%, Positive predictive value 90.62%, Negative predictive value 94.44%. Out of 50 patients 29 had positive DPL wrongly positive in 3 patients, true negative in 17 patients, false negative in 1 patient. 3 patients falsely negative on abdominal ultrasonography, 2 of them were having gut contents on DPL and 1 was having frank blood on DPL.Focused Assessment Sonography for Trauma [FAST] being non invasive should be the first step in assessment of patients with blunt abdominal trauma, when complimented by DPL may helps in defining the organ injury