Skip to main content
SpringerLink
Log in

Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen—A Prospective Study

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Focused assessment with sonography for trauma (FAST) is a limited ultrasound examination, primarily aimed at the identification of the presence of free intraperitoneal or pericardial fluid. In the context of blunt trauma abdomen (BTA), free fluid is usually due to hemorrhage, bowel contents, or both; contributes towards the timely diagnosis of potentially life-threatening hemorrhage; and is a decision-making tool to help determine the need for further evaluation or operative intervention. Fifty patients with blunt trauma abdomen were evaluated prospectively with FAST. The findings of FAST were compared with contrast-enhanced computed tomography (CECT), laparotomy, and autopsy. Any free fluid in the abdomen was presumed to be hemoperitoneum. Sonographic findings of intra-abdominal free fluid were confirmed by CECT, laparotomy, or autopsy wherever indicated. In comparing with CECT scan, FAST had a sensitivity, specificity, and accuracy of 77.27, 100, and 79.16 %, respectively, in the detection of free fluid. When compared with surgical findings, it had a sensitivity, specificity, and accuracy of 94.44, 50, and 90 %, respectively. The sensitivity of FAST was 75 % in determining free fluid in patients who died when compared with autopsy findings. Overall sensitivity, specificity, and accuracy of FAST were 80.43, 75 and 80 %, respectively, for the detection of free fluid in the abdomen. From this study, we can safely conclude that FAST is a rapid, reliable, and feasible investigation in patients with BTA, and it can be performed easily, safely, and quickly in the emergency room with a reasonable sensitivity, specificity, and accuracy. It helps in the initial triage of patients for assessing the need for urgent surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Timothy CF, Martin AC (2000) Abdominal trauma. In: Mattox KL, Feliciano DV, Moore EE (eds) Trauma, 4th edn. McGraw-Hill, USA, p 583

    Google Scholar 

  2. Rozycki GS, Ochsner MG, Schmidt JA, Frankel HL, Davis TP, Wang D et al (1995) A prospective study of surgeon-performed ultrasound as the primary adjuvant modality for injured patient assessment. J Trauma 39:492–8

    Article  PubMed  CAS  Google Scholar 

  3. Ingeman JE, Plewa MC, Okasinski RE, King RW, Knotts FB (1996) Emergency physician use of ultrasonography in blunt abdominal trauma. Acad Emerg Med 3:931–7

    Article  PubMed  CAS  Google Scholar 

  4. Kristensen JK, Buemann B, Kühl E (1971) Ultrasonic scanning in the diagnosis of splenic haematomas. Acta Chir Scand 137(7):653–657

    PubMed  CAS  Google Scholar 

  5. Ascher WM, Parvin S, Virgilio RW (1976) Echographic evaluation of splenic injury after blunt trauma. Radiology 118:411–415

    Article  Google Scholar 

  6. Raum MR, Bouillon B, Eypasch E, Tiling T (1997) Technology assessment of ultrasound in acute diagnosis of blunt abdominal trauma. Langenbecks Arch Chir Suppl Kongressbd 114:461–464

    PubMed  CAS  Google Scholar 

  7. Chiu WC, Cushing BM, Rodriguez A, Ho SM, Mirvis SE, Shanmuganathan K et al (1997) Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma (FAST). J Trauma 42:617–622

    Article  PubMed  CAS  Google Scholar 

  8. Bode PJ, Niezen RA, van Vugt AB, Schipper J (1993) Abdominal ultrasound as a reliable indicator for conclusive laparotomy in blunt abdominal trauma. J Trauma 34:27–31

    Article  PubMed  CAS  Google Scholar 

  9. Liu M, Lee CH, P’eng FK (1993) Prospective comparison of diagnostic peritoneal lavage, computed tomographic scanning, and ultrasonography for the diagnosis of blunt abdominal trauma. J Trauma 35:267–270

    Article  PubMed  CAS  Google Scholar 

  10. Branney SW, Wolfe RE, Moore EE, Albert NP, Heinig M, Mestek M et al (1995) Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma 39:375–380

    Article  PubMed  CAS  Google Scholar 

  11. Chambers JA, Pilbrow WJ (1988) Ultrasound in abdominal trauma: an alternative to peritoneal lavage. Arch Emerg Med 5:26–33

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  12. Jehle D, Guarino J, Karamanoukian H (1993) Emergency department ultrasound in the evaluation of blunt abdominal trauma. Am J Emerg Med 11:342–346

    Article  PubMed  CAS  Google Scholar 

  13. Healy MA, Simons RK, Winchell RJ et al (1996) A prospective evaluation of abdominal ultrasound in blunt trauma: is it useful? J Trauma 40:875

    Article  Google Scholar 

  14. Richards JR, Schleper NH, Woo BD, Bohnen PA, McGahan JP (2002) Sonographic assessment of blunt abdominal trauma: a 4-year prospective study. J Clin Ultrasound 30(2):59–67

    Article  PubMed  Google Scholar 

  15. Adams B, Sisson C (2012) Review: bedside ultrasonography has 82% sensitivity and 99% specificity for blunt intraabdominal injury. Ann Intern Med 157(4):2–12

    Article  Google Scholar 

  16. Fleming S, Bird R, Ratnasingham K, Sarker SJ, Walsh M, Patel B (2012) Accuracy of FAST scan in blunt abdominal trauma in a major London trauma centre. Int J Surg 10(9):470–4

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No financial grant has been received for this study.

Author information

Authors and Affiliations

  1. Department of Surgery, All India Institute of Medical Sciences, New Delhi, India

    Subodh Kumar, Virinder Kumar Bansal, Dillip Kumar Muduly, Pawan Sharma & Mahesh C. Misra

  2. Department of Surgery, All India Institute of Medical Sciences, New Delhi, India

    Sunil Chumber

  3. Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India

    Saraman Singh

  4. Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, India

    D. N. Bhardwaj

  5. Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029, India

    Virinder Kumar Bansal

Authors
  1. Subodh Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Virinder Kumar Bansal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dillip Kumar Muduly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pawan Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mahesh C. Misra
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sunil Chumber
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saraman Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. N. Bhardwaj
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Virinder Kumar Bansal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kumar, S., Bansal, V.K., Muduly, D.K. et al. Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen—A Prospective Study. Indian J Surg 77 (Suppl 2), 393–397 (2015). https://doi.org/10.1007/s12262-013-0851-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-013-0851-2

Keywords

Search

Navigation