EVALUATION OF EFFICIENCY OF CT SCAN AND FAST SCAN IN PATIENTS WITH BLUNT TRAUMA ABDOMEN

ABSTRACT Objective: The main aim of this study was to find the efficiency of CT and Fast scan in patients who present in emergency department with blunt trauma to the abdomen. Place and Duration of Study: This study was carried out in Jinnah hospital Lahore in a duration of 7 months from January 2019 to July 2019. Material and Methods: Patients presenting in the emergency with blunt trauma to the abdomen and who were vitally stable were included in this study. After giving initial trauma protocol patients were sent for CT and Fast scan along with routine investigations. Upon finding a positive sign either in CT or FAST scan patients were informed about the study and consent was taken. Patients were first sent for FAST scan which was followed by CT scan. Patients with negative scans were excluded from this study. X-ray of the abdomen and chest were also obtained to rule out other abnormalities. CT scan was obtained in all these patients even if negative results were seen in patients. Both scans were obtained in all these patients even after abnormalities were seen on FAST scan. Along with analyzing all the organs, the main focus was kept upon the presence of free fluid in abdomen and pelvis. NG tube was passed to decompress the stomach to remove the air. Oral and IV contrasts were given for better results. Having the suspicion of renal injury, delayed scan was performed. The patients in which any fluid or visceral injury was seen in abdomen, were labeled as positive and in which no findings were seen were labeled as negative. Results: A total of 56 patients were included in this study having 12 females and 44 males. 18 to 40 years was the most common age group who presented in emergency. Trauma was most commonly due to RTA 58.9% which was followed by fall from height 32.1%. Sports injuries included 7.1% and history of fight 0.18%. Organs which were most commonly injured included 73.2% liver, kidneys in case of 46.4%, spleen 51.8% and pancreas 12.5%. Both CT and FAST scans were done in these 56 patients. In 49 (87.5%) positive findings were seen with FAST scan but it was missed in 7 (12.5%) of the patients and findings were missed only in 1 (1.8%) case with CT scan. On the basis of fluid, hemoperitoneum was classified in 3 groups i.e. mild, moderate and severe. Presence or fluid only in one space with fluid quantity about 100-200 ml was labeled as mild. Moderate was defined as presence of fluid in 2 pelvic spaces with fluid quantity of about 250-500ml. Presence of fluid in all spaces with quantity exceeding 500 was labeled as gross