Focused Assessment with Sonography in Trauma (FAST) Scans Are Not Sufficiently Sensitive to Rule out Significant Injury in Pediatric Trauma Patients
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چکیده
Aim: To assess the sensitivity and specificity of FAST scans in pediatric trauma in a dedicated pediatric trauma centre. Method: A 3-year (2008-2011) analysis of prospectively collected data looking at the results of FAST scans compared to Computed Tomography (CT) or laparotomy findings. Results: There were 482 pediatric trauma calls of which 166 patients had suspected intra-abdominal injury. 163 patients underwent CT scans of which 89 (55%) had FAST scans prior to CT. 3 patients had FAST scans without CT; 1 patient went straight to theatre (positive FAST) and 2 patients died in the department before any further imaging. The sensitivity of FAST scans to detect abdominal injury is 23% and the specificity is 97%. The injuries missed on FAST scan were: liver lacerations (n = 3), splenic lacerations (n = 5), 1 combined liver and kidney injury and 1 combined splenic injury and small bowel perforation. Conclusions: FAST scans in trauma have a low sensitivity in pediatric patients with the possibility of missing significant intra-abdominal injury. They do not obviate the need for CT scan when clinical suspicion is high.
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تاریخ انتشار 2014