Prospective Comparison of Diagnostic Peritoneal Lavage (DPL) and Focused Abdominal Sonography for Trauma (FAST) for the Diagnosis of Hemoperitoneum in Blunt and Penetrating Abdominal Trauma
Abstract
Background: Clinical assessment of intra-abdominal injury following blunt or penetrating trauma may be unreliable, due to the alteration of consciousness, neurological deficit, medications or other associated injuries. Diagnostic peritoneal lavage (DPL) is more accurate than physical examination in assessing abdominal injury. However, it is an invasive procedure and carries risk of organ injuries. Focused Abdominal Sonography for Trauma (FAST) is a focused assessment of the abdomen which is safe, non-invasive, inexpensive and painless and can be completed within 3 minutes.
Materials and Methods: Over a 12 months period from January 2006 to January 2007, FAST was performed in all abdominal trauma patients with indications for DPL. The results were compared with traditional DPL by open technique.
Results: Fifty four patients with abdominal injury were evaluated by FAST and the results were compared with the results of DPL. Forty-eight patients had positive FAST and positive DPL. Five patients had negative FAST but positive DPL. Only one patient had negative FAST and negative DPL. No patient had FAST positive but negative DPL.. The sensitivity and specificity of FAST compared to DPL for detection of hemoperitoneum in this study were 91% and 100%, respectively.
Conclusion: FAST is an efficient and accurate method in the evaluation of hemoperitoneum in blunt and penetrating abdominal trauma compared with DPL.
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