• Logo
  • SBMUJournals

Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

Firooz Behboodi, Zahra Mohtasham-Amiri, Navid Masjedi, Reza Shojaie, Peyma Sadri



Introduction: Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy.


Abdominal injuries; wounds, nonpenetrating; patient outcome assessment; ultrasonography; tomography, X-ray computed


Miniño AM, Heron MP, Murphy SL, Kochanek KD. Deaths: final data for 2004. Natl Vital Stat Rep. 2007;55:1-119.

Hofman K, Primack A, Keusch G, Hrynkow S. Addressing the growing burden of trauma and injury in low-and middle-income countries. Am J Public Health. 2005;95(1):13-7.

Sabzghaba A, Shojaee M, Safari S, Hatamabadi HR, Shirvani R. The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas. Emergency. 2015;3:[In press].

Chardoli M, Rahimi-Movaghar V. Analysis of trauma outcome at a university hospital in Zahedan, Iran using the TRISS method. East Afr Med J. 2006;83(8):440-2.

Shojaee M, Faridaalaee G, Yousefifard M, et al. New scoring system for intra-abdominal injury diagnosis after blunt trauma. Chin J Traumatol. 2014;17(1):19-24.

Scalea TM, Rodriguez A, Chiu WC, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma Acute Care Surg. 1999;46(3):466-72.

Soundappan S, Holland A, Cass D, Lam A. Diagnostic accuracy of surgeon-performed focused abdominal sonography (FAST) in blunt paediatric trauma. Injury. 2005;36(8):970-5.

Patel JC, Tepas J. The efficacy of focused abdominal sonography for trauma (FAST) as a screening tool in the assessment of injured children. J Pediatr Surg. 1999;34(1):44-7.

Chiu WC, Cushing BM, Rodriguez A, et al. Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma (FAST). J Trauma Acute Care Surg. 1997;42(4):617-25.

Allen CJ, Tashiro J, Sola JE. Role of FAST or Abdominal Ultrasound to Limit CT Imaging in Evaluation of the Pediatric Abdominal Trauma Patient. Curr Surg Report. 2014;2(6):1-5.

Ben-Ishay O, Daoud M, Peled Z, Brauner E, Bahouth H, Kluger Y. Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma. World J Emerg Surg. 2015;10(1):27.

Wu C-Y, Yang S-J, Fu C-Y, et al. The risk factors of concomitant intraperitoneal and retroperitoneal hemorrhage in the patients with blunt abdominal trauma. World J Emerg Surg. 2015;10(1):4.

Cunningham MA, Tyroch AH, Kaups KL, Davis JW. Does free fluid on abdominal computed tomographic scan after blunt trauma require laparotomy. J Trauma Acute Care Surg. 1998;44(4):599-603.

Yanar H, Ertekin C, Taviloglu K, Kabay B, Bakkaloglu H, Guloglu R. Nonoperative treatment of multiple intra-abdominal solid organ injury after blunt abdominal trauma. J Trauma Acute Care Surg. 2008;64(4):943-8.

Haan JM, Bochicchio GV, Kramer N, Scalea TM. Nonoperative Management of Blunt Splenic Injury: A 5-Year Experience. J Trauma Acute Care Surg. 2005;58(3):492-8.

Fox JC, Boysen M, Gharahbaghian L, et al. Test Characteristics of Focused Assessment of Sonography for Trauma for Clinically Significant Abdominal Free Fluid in Pediatric Blunt Abdominal Trauma. Acad Emerg Med. 2011;18(5):477-82.

Kelley SR, Tsuei BJ, Bernard AC, Boulanger BR, Kearney PA, Chang PK. The effectiveness of focused assessment with sonography for trauma in evaluating blunt abdominal trauma with a seatbelt mark sign. J Curr Surg. 2014;4(1):17-22.

DOI: https://doi.org/10.22037/emergency.v4i3.9894


  • There are currently no refbacks.