Focused Assessment with Sonography for Trauma (FAST) Scan Versus Exploratory Laparotomy in Patients with Blunt Abdominal Trauma

Abstract

Objective: To determine the diagnostic accuracy of FAST scans in patients with blunt abdominal trauma keeping exploratory laparotomy as a gold standard.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Surgical Unit of Combined Military Hospital Kohat from Jan 2019 to June 2019.

Methodology: Trauma patients reporting to the emergency department had a FAST scan using a portable ultrasound machine. The radiologist performed and interpreted the scans within one hour of the patient's arrival. The four standard views were obtained. Those who had positive FAST scans underwent a laparotomy without further evaluation. Patients with negative FAST scans did not have laparotomy unless unstable. Only those patients who underwent laparotomy were included in our study.

Results: Out of 70 cases, comparison of the FAST scans in patients with blunt abdominal trauma keeping exploratory laparotomy as the gold standard to diagnose intra-abdominal injury was recorded as 88.88%, 82.35%, 94.00%, 70.00% and 87.14% for sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy respectively.

Conclusion: Diagnostic accuracy of FAST scan in diagnosing intra-abdominal injury is higher, so it can be used routinely to diagnose intra-abdominal injury as a result of blunt abdominal trauma