Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": The role of repeated ultrasonography

To determine the diagnostic Accuracy of Focused Assessment Sonography for Trauma (FAST) and
repeated FAST in the patients with blunt abdominal trauma.
Methods: In this retrospective study we collected the data of all patients from September 2007 to July 2011 with
gastrointestinal injury. The intraoperative outcome was compared with FAST technique and the repeated or
delayed sonography.
Results: A total number of 1550 patients with blunt abdominal trauma underwent FAST in a period of 4 years in
our hospital. Eighty-eight (5.67%) patients were found to have gastrointestinal injury after exploratory laparotomy.
Fifty-five (62.5%) patients had isolated gastrointestinal injury and 33 (37.5%) patients had concomitant injury to the
other solid organs. In those with isolated gastrointestinal injury, the sensitivity of FAST was 38.5%. Repeated
ultrsonography was performed in 34 patients with false negative initial FAST after 12-24 hours. The sensitivity of
repeated ultrasonography in negative initial FAST patients in detection of gastrointestinal injury was 85.2% (95% CI,
68.1%, and 94.4%).
Conclusion: Repeated sonography after 12 to 24 hours in patients with negative initial FAST but sustain
abdominal symptom can facilitated a diagnosis of GI tract injury and can be as effective method instead of
Computed tomography in developing country.