A prospective study to assess the accuracy of Diagnostic Focussed Abdominal Sonography for Trauma (FAST) in blunt abdominal trauma among the patients presenting to Govt. Rajaji Hospital, Madurai

Vanitha, P (2015) A prospective study to assess the accuracy of Diagnostic Focussed Abdominal Sonography for Trauma (FAST) in blunt abdominal trauma among the patients presenting to Govt. Rajaji Hospital, Madurai. Masters thesis, Madurai Medical College, Madurai.

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Abstract

BACKGROUND AND OBJECTIVE: In view of increasing number of road traffic accidents and blunt abdominal injury and its lethal & fatal complications ,FAST is an essential and necessarycomponent of trauma management. Hence this study is undertaken. The Objectives of our study were to asses the diagnostic acuracy of focussed assessment with sonography in detecting intra abdominal free fluid after blunt abdominal injuries.. METHODS: Govt. Rajaji hospital ,Madurai, admits all the victims of Blunt Abdominal Trauma in Trauma ward. 50 consecutive patients with history of blunt abdominal trauma attending or taken to our hospital 01/01/2014 to 31/12/2014 were included in the study. Inclusion and exclusion criteria were defined, and applied to all patients. All the 50 patients were underwent FAST protocol examination for evidence intra-abdominal free fluid. Patients were grouped in to 2 categories based on presence of free fluid (FAST +ve) and absence of free fluid (FAST -ve).FAST findings were compared with gold standards like laporatomy findings and in conservatively teated patients , with CT scan findings. Stastical analysis was done by Sensitivity and Specificity. RESULTS: 50 patient with history of blunt abdominal truama were included in the study , out of which 36 wre males and 14 wre females.Most of the petients in the age group of 20-50 yrs.RTA was the most comman mechanism of trauma seen in 35 patients.30 patients presented with hypotention . FAST findings were positive in 38 patients and negative in 12 patients.34 patients were underwent laparotomy and 16 patients were treated conservatively. Specificity of FAST was 100% in comparison with laparotomy findings and 60% when compared to CT findings.The sensitivity was 84% comparison with laparotomy findings and 72% when compared to CT findings. FAST has +ve predictive value of 100% and 80% in comparison with laparotomy and CT Scan findings respectively. The negative predictive value of FAST found to be 16% and 50% in comparison with laparotomy and CT Scan findings respectively. INTERPRETATION &CONCLUSION: In our study we noted that the most common cause or mechananism of trauma causing blunt abdominal trauma was Road traffic accidents. Males were most commanly affected. The average btime taken for FAST examination was 10 minutes . Most of the patients prewsented with pain abdomen and hypotension Splenic and Liver laceration were the most common organ injury. FAST has the 84% diagnostic accuracy in detecting the organ injury in blunt abdominal trauma. We conclude that the advantage of FAST protocol is harmless ,non-invasive quick, portable,accurate, repeattable and can be done during resuscitation. It does not interfere with other investgations especially in hemo dynamically unfit patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Blunt abdominal injury ; focussed abdominal sonography ; ultrasonography.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 22 Oct 2017 10:00
Last Modified: 22 Oct 2017 10:00
URI: http://repository-tnmgrmu.ac.in/id/eprint/3832

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