Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies
Introduction: Focused assessment with sonography for trauma (FAST) is an important adjunct for quickly detecting intra-abdominal hemorrhage. The study was aimed to identify the incidence of non-therapeutic laparotomies with positive FAST result and pelvic fracture. Materials and Methods: A retrospec...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Indian Orthopaedic Research Group
2025-04-01
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| Series: | Journal of Orthopaedic Case Reports |
| Subjects: | |
| Online Access: | https://jocr.co.in/wp/2025/04/01/limitations-of-focused-assessment-with-sonography-for-trauma-in-pelvic-trauma-a-retrospective-review-of-false-positive-results-and-non-therapeutic-laparotomies/ |
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| Summary: | Introduction:
Focused assessment with sonography for trauma (FAST) is an important adjunct for quickly detecting intra-abdominal hemorrhage. The study was aimed to identify the incidence of non-therapeutic laparotomies with positive FAST result and pelvic fracture.
Materials and Methods:
A retrospective review of prospectively maintained data was conducted to identify cases of pelvic fracture with positive FAST results. Cases with non-therapeutic laparotomies were analyzed for the cause of false FAST positive result. The data were collected and analyzed for the mechanism of injury, associated injuries and injury severity.
Results:
Out of 195 cases of pelvic fracture with positive FAST result, only 5 cases (2.5%) had non-therapeutic laparotomies. Most were operated without a computed tomography scan due to hemodynamic instability. One patient was operated in view of peritonitis. Most common type of the injury requiring operative intervention was a vertical shear fracture. One patient was managed with an immediate external fixator, while three underwent a definitive pelvis fixation at a later date. One patient was managed conservatively.
Conclusion:
FAST has a high sensitivity for intra-abdominal bleeding. However, retroperitoneal hematoma in pelvic fractures can lead to false-positive FAST results. Therefore, we advocate for a comprehensive approach encompassing clinical judgment, additional imaging for stable patients, the engagement of a multidisciplinary team, and surgical expertise to ensure optimal patient care and outcomes. |
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| ISSN: | 2250-0685 2321-3817 |