Akhtar Hussain Phul, Azhar Ali Shah, Nosheen, Imamuddin Baloch.
Efficacy & accuracy of focused assessment sonography for trauma (FAST) in management of isolated gastrointestinal injury due to blunt abdominal trauma.
Pak J Med Res Jan ;55(2):40-3.

Objective: To determine the diagnostic accuracy of Focused Assessment Sonography for Trauma (FAST) in patients having isolated gastrointestinal injury due to blunt abdominal trauma. Study design, settings and duration: Prospective, interventional study was done in department of General Surgery & Diagnostic Radiology, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from July 2012 to June 2014. Materials and Methods: All patients who came with blunt abdominal trauma underwent emergency ultrasound with FAST technique to detect free fluid/ collection in abdominal cavity as an indicator of intra-abdominal organ injury. After ultrasound examination, most patients underwent surgical laparotomy to identify the gut and solid organ injury and were managed accordingly. The surgical findings were compared with ultrasound findings to see the correlation. Results: A total of 317 patients with blunt abdominal trauma underwent emergency US with FAST technique. Out of these, 296 (93.37%) underwent exploratory laparotomy. During surgery, 52 (17.56%) patients had evidence of bowel injury with 38 (12.83%) having solid organ injury plus bowel injury and 14 (4.72%) having only bowel injury. Amongst them, FAST ultrasound showed free fluid/ collection in 28 (53.8%) patients (true positive) while it was negative in 24 (46.15%) patients (false negative). Among these, 24 patients with negative FAST, 15 (62.5%) had both solid organ injury plus bowel injury and 09 (37.5%) had only bowel injury (False negative). Conclusion: FAST ultrasound missed 46% bowel injury with or without other solid organ injury and is therefore not reliable in diagnostic tool for assessing isolated bowel injury due to blunt abdominal trauma. Key words: Blunt abdominal trauma, gastrointestinal injury, FAST.

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