MRCS Trauma

Q1.) 30 year old male comes to emergency with road side accident, He is conscious, responding to commands, has abdominal distension, Pulse 125/min and BP is 84/44. Initial investigation of choice?

a) CT Abdomen

b) Angiography of Abdomen

c) Ultrasound of abdomen

d) X ray abdomen

A1. c

FAST A focused abdominal sonography for trauma (FAST) scan  may  be useful in this scenario to locate the major source of haemorrhage . Angiography and CT are ruled out in unstable patient. X ray will not help much

eFAST is accurate at detecting >100 mL of free blood; however, it is very operator dependent and, especially if the patient is very obese or the bowel is full of gas, it may be unreliable. Hollow viscus injury and solid organ injury are difficult to diagnose, even in experienced hands, as small amounts of gas or fluid
are difficult to assess, and eFAST a low sensitivity (29–35%) for organ injury without haemoperitoneum.

Ref BAiley 27th 372