Application of emergency bedside focused assessment with sonography for trauma together with regional organ focused ultrasonography in closed abdominal trauma / 中华创伤杂志

ABSTRACT

Objective To investigate the value of emergency bedside focused assessment with sonography for trauma (FAST) in combination with regional organ focused ultrasonography in patients with closed abdominal trauma.Methods Two hundred and thirty-seven patients with closed abdominal trauma underwent bedside ultrasonography in the Emergency Department at General Hospital of Chengdu Military Command.In patients with unstable hemodynamics or severe craniocerebral injury,ultrasonography was ended immediately after FAST screening.In patients with stable vital signs,the focused regional organ injury after FAST screening was determined based on the mechanism of trauma,action location and direction of external force,abdominal symptoms,and signs.The results of operation and CT scanning were considered as golden criteria and used to compare with those of ultrasonography.Results (1) The diagnostic sensitivity of FAST to abdominal organ rupture and ascites due to abdominal organ rupture calling for emergency operation was 79.3％ and 100％,respectively.The total specificity of FAST was 98.2％,positive predictive value 93.9％,and negative predictive value 86.7％.(2) The diagnostic accordance rate of single visceral injury examined by regional organ focused ultrasonography was 91.2％ and that of multiple visceral injury was 63.6％.The missed diagnoses were predominantly contusion and microlaceration.Conclusions FAST can quickly screen out the patients with unstable hemodynamics due to abdominal organ rupture calling for emergency management.Regional organ focused ultrasonography can increase the rate of correct diagnosis of visceral injury and decrease the rate of missed diagnosis.