Ultrasound examination in closed abdominal trauma with damage to parenchymal organs

Authors

  • D. B. Fira I. Horbachevsky Ternopil National Medical University
  • P. O. Gerasymchuk I. Horbachevsky Ternopil National Medical University
  • N. O. Dobrynska Municipal Non-Profit Organization “Ternopil City Municipal Emergency Hospital”
  • A. V. Pavlyshyn I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2022.4.13536

Keywords:

closed abdominal trauma, ultrasound examination, FAST protocol

Abstract

The aim of the work: to study the effectiveness and diagnostic value of ultrasound examination according to the FAST protocol in closed abdominal trauma with damage to parenchymal organs.

Materials and Methods. The results of the use of ultrasound examination according to the FAST protocol in the diagnosis of closed abdominal trauma with damage to parenchymal organs in 119 patients were retrospectively analyzed.

Results and Discussion. An urgent ultrasound of the abdominal cavity was carried out in all patients at the stage of hospitalization, which allowed to establish the presence of damage to parenchymal organs by direct or indirect signs.

Free fluid in the abdominal cavity, as an indirect sign of damage, was diagnosed in 89 (74.8 %) patients upon admission.

At the time of admission, free fluid in the abdominal cavity could not be detected in 19 (16.0 %) patients, but its appearance was diagnosed during further ultrasound monitoring of the victims during the day.

In 24 (20.2 %) patients, direct signs of spleen damage were diagnosed during the primary ultrasound, and in 7 (5.9 %) patients – liver.

Subcapsular or intra-organ hematomas without hemoperitoneum formation were found in 8 (6.7 %) patients with liver injuries and in 11 (9.2 %) patients with spleen injuries. 21 (17.6 %) patients in critical condition with unstable hemodynamic parameters were immediately sent to the operating room or intensive care unit, where the FAST protocol was performed. Changes in the echogenicity and structure of tissues, contours of parenchymal organs, their defects, changes in blood circulation, and hemoperitoneum served as indications for urgent surgical treatment.

Ultrasound examination of the abdominal cavity in case of a closed trauma with damage to parenchymal organs according to the FAST protocol allows to diagnose the damage in the shortest possible time and to decide on the tactics of treatment. Its informativeness in the diagnosis of parenchymal organ damage in closed abdominal trauma is 96.7 %, specificity – 94.6 %, sensitivity – 90.8 %.

The widespread implementation of the FAST protocol in the diagnostic program of closed abdominal trauma is a mandatory basic non-invasive study, which allows you to decide on treatment tactics in a short period of time and reduce the level of more traumatic laparocentesis and unfounded surgical interventions.

References

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Published

2022-12-29

How to Cite

Fira, D. B., Gerasymchuk, P. O., Dobrynska, N. O., & Pavlyshyn, A. V. (2022). Ultrasound examination in closed abdominal trauma with damage to parenchymal organs. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 79–84. https://doi.org/10.11603/2414-4533.2022.4.13536

Issue

No. 4 (2022)

Section

EXPERIENCE OF WORK

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