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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| Format: | Article |
| Language: | English |
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Indian Orthopaedic Research Group
2025-04-01
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| Series: | Journal of Orthopaedic Case Reports |
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| 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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| author | Pankaj Kumar Swastik Sourav Mishra Mantu Jain Sujit Tripathy Kasthala Sanjay Raj Siddharth Satyakam Pradhan |
| author_facet | Pankaj Kumar Swastik Sourav Mishra Mantu Jain Sujit Tripathy Kasthala Sanjay Raj Siddharth Satyakam Pradhan |
| author_sort | Pankaj Kumar |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-91bea5b5208549e795a10240a4e835ea |
| institution | OA Journals |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-91bea5b5208549e795a10240a4e835ea2025-08-20T02:08:00ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-04-0115424525110.13107/jocr.2025.v15.i04.5512Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic LaparotomiesPankaj KumarSwastik Sourav MishraMantu JainSujit TripathyKasthala Sanjay RajSiddharth Satyakam PradhanIntroduction: 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.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/abdominal traumafocused assessment with sonography for traumapelvis fracture |
| spellingShingle | Pankaj Kumar Swastik Sourav Mishra Mantu Jain Sujit Tripathy Kasthala Sanjay Raj Siddharth Satyakam Pradhan Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies Journal of Orthopaedic Case Reports abdominal trauma focused assessment with sonography for trauma pelvis fracture |
| title | Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies |
| title_full | Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies |
| title_fullStr | Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies |
| title_full_unstemmed | Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies |
| title_short | Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies |
| title_sort | limitations of focused assessment with sonography for trauma in pelvic trauma a retrospective review of false positive results and non therapeutic laparotomies |
| topic | abdominal trauma focused assessment with sonography for trauma pelvis fracture |
| url | 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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