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World Journal of Emergency Surgery

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Open Access 01-12-2015 | Research article

Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma

Authors: Offir Ben-Ishay, Mai Daoud, Zvi Peled, Eran Brauner, Hany Bahouth, Yoram Kluger

Published in: World Journal of Emergency Surgery | Issue 1/2015

Abstract

Introduction

In pediatric care, the role of focused abdominal sonography in trauma (FAST) remains ill defined. The objective of this study was to assess the sensitivity and specificity of FAST for detecting free peritoneal fluid in children.

Methods

The trauma registry of a single level I pediatric trauma center was queried for the results of FAST examination of consecutive pediatric (<18 years) blunt trauma patients over a period of 36 months, from January 2010 to December 2012. Demographics, type of injuries, FAST results, computerized tomography (CT) results, and operative findings were reviewed.

Results

During the study period, 543 injured pediatric patients (mean age 8.2 ± 5 years) underwent FAST examinations. In 95 (17.5 %) FAST was positive for free peritoneal fluid. CT examination was performed in 219 (40.3 %) children. Positive FAST examination was confirmed by CT scan in 61/73 (83.6 %). CT detected intra-peritoneal fluid in 62/448 (13.8 %) of the patients with negative FAST results. These findings correspond to a sensitivity of 50 %, specificity of 88 %, positive predictive value (PPV) of 84 %, and a negative predictive value (NPV) of 58 %. In patients who had negative FAST results and no CT examination (302), no missed abdominal injury was detected on clinical ground. FAST examination in the young age group (<2 years) yielded lower sensitivity and specificity (36 and 78 % respectively) with a PPV of only 50 %.

Conclusions

This study shows that although a positive FAST evaluation does not necessarily correlate with an IAI, a negative one strongly suggests the absence of an IAI, with a high NPV. These findings are emphasized in the analysis of the subgroup of children less than 2 years of age. FAST examination tempered with sound clinical judgment seems to be an effective tool to discriminate injured children in need of further imaging evaluation.

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Title: Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma
Authors: Offir Ben-Ishay
Mai Daoud
Zvi Peled
Eran Brauner
Hany Bahouth
Yoram Kluger
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2015
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-015-0021-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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