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A Comparative Study to Assess the Accuracy of Diagnostic Focussed Abdominal Sonography for Trauma (FAST) In Blunt Abdominal Trauma
Authors: Sandeep. Naik, Shimikore. S. S, Pavan P. Havaldar, Shaik Hussain Saheb.
Number of views: 292
Background and Objective: In view of increasing number of vehicular accidents and blunt abdominal injury and its lethal & fatal complications, FAST is an essential and necessary component of trauma management. Hence this study is undertaken. The objectives of our study were to assess the diagnostic accuracy of focussed Abdominal sonography for Trauma in the detection of intra-abdominal free fluid following blunt abdominal injury.
Methods: KLE’s Dr.Prabhakar kore Hospital and Medical Research Centre, Belgaum, affiliated to KLE University, admits all the victims of Blunt Abdominal Trauma. 50 consecutive patients with history of blunt abdominal trauma attending or taken to KLE,s Hospital from 01/01/2007 to 31/12/2007 were included in the Study. All the 50 patients underwent FAST protocol examination for evidence of intra-abdominal free fluid. Patients were grouped into 2 categories based on presence of free fluid (FAST +) and absence of free fluid (FAST -). FAST findings were compared with gold standards like laparotomy findings and in conservatively treated patients, with CT Scan findings. Statistical analysis was done by calculating Sensitivity and Specificity.
Results: 50 patients with history of BAT were included in the study, out of which 36 were male and 14 were female. Most of the patients were in the age group of 20-40 years (age range: 4 -75 years). 35 patients presented with hypotension. FAST findings were positive in 38 patients and negative in 12 patients. 34 patients underwent laparotomy and 16 patients were treated conservatively.Specificity of FAST was 100% in comparison with laparotomy findings and 60% when compared to CT Scan findings. The Sensitivity was 84% in comparison with laparotomy findings and 72% when compared to CT Scan findings.
Conclusion: We conclude that the advantages of FAST Protocol are that it is harmless, non-invasive rapid , portable , accurate , repeatable and can be performed during resuscitation. It does not prejudice other investigations especially in hemodynamically unstable patients.
KEY WORDS: Blunt Abdominal Trauma, Focussed Abdominal Sonography, Ultrasonography.