FOCUSED ASSESSMENT WITH SONOGRAPHY FOR TRAUMA CORRELATED WITH INTRAOPERATIVE FINDINGS AMONG PATIENTS WITH BLUNT ABDOMINAL TRAUMA.

Peter Cyril Mhina; Ester Lazaro; Felista Gerald Uisso; Crispin Constantine Moshi

doi:10.5455/ajdi.20240515042632

Abstract
ABSTRACT.
Aim: The aim of this study was to assess the correlation between FAST examination with intraoperative findings among patients with blunt abdominal trauma.
Methods: This retrospective cross-sectional study was conducted at Kilimanjaro Christian Medical Centre from January 2022 to December 2022. Data collection started on September 15th, 2022 to September 14th, 2023 and the analysis was conducted thereafter. A total of 77 post-traumatic patients were enrolled. The FAST findings were then compared with intraoperative ones. The parameters evaluated included hemoperitoneum and injury to the visceral organs.
Results: The mean age of the participants was 37.7 years (18.9 SD). The mechanism of injury was RTA 49(63.6%), fall from height 15(19.5%), assaults 10(13.0%) and other cause (3.9%). The dependent sites for fluid collection during FAST examination was hepatorenal space 43(55.8%) followed by rectovesical space and splenorenal recess by 36(46.7%) and 31(40.3%) respectively. Visceral injuries observed during laparotomy, the bowels, liver, spleen and the urinary bladder were 36(46.8%), 26(33.8%), 23(29.9) and 8(10.4%) respectively. FAST showed a 97.4% PPV. The rate of detection of solid organ injury shown by FAST against laparotomy was found to be 21.4%.
Conclusions: A high incidence of BAT of more than 50% was seen in the economically active age group of 21 to 45 years, reflecting their participation in high-risk activities that expose them to trauma. This demands an urgent public policy response. In this study, FAST examination showed better results in detecting the presence of hemoperitoneum than in detecting injury to the visceral organs.

Key words: Focused assessment with sonography for trauma (FAST), Laparotomy, Blunt abdominal trauma (BAT)