Presentation
Patient post blunt abdominal trauma.
Patient Data
The upper abdominal organs (liver = 13.2 cm measured longitudinally; spleen = 9.54 x 2.93 cm; right and left kidneys = 7.94 x 4.32 cm and 10.5 x 4.06 cm respectively; and the pancreas) are orthotopic, normal in their sizes, shapes and parenchymal echo pattern. No evidence of organ fractures, lacerations, or contusions. The acalculus gallbladder is normal in distension (7.54 x 2.65 cm) with no evidence of wall thickening or peripheral pathology. No evidence of visceral node enlargement, abdominal masses, or free intra-peritoneal fluid collection.
The heart and its associated chambers and myocardial plus the visualized peri-cardiac areas are normal with no pathology. HR = 91 BPM and regular. The bilateral hemidiaphragm, the paracolic/mesocolic gutters, and the iliac flanks, as well as the bilateral external iliac arteries and veins (some images not shown), are normal. The urinary bladder is normal in distension with no evidence of wall ruptures or intravesical hematomas. The pelvic floor is clear.
Conclusion:
a negative extended FAST examination
follow-up recommended
Case Discussion
A negative extended FAST examination (normal) is highlighted for reference. Of importance is to keenly exclude major organ fractures or bruises or lacerations and to also exclude free fluid collections within the intra-abdominal-pelvic potential spaces. Again, the abdominal-pelvic vasculature, gallbladder, urinary bladder, cardiac, cardiac rhythms and pericardial areas, and bowels are assessed for any anomaly 1.
The bilateral hemidiaphragm, para, meso, infra, and supra-colic gutters are assessed as well and while at it, rapid peeping of the bilateral pleural spaces at the lower lung bases is evaluated 2. One should remember to recommend a follow-up scan even in a normal/ negative FAST examination routinely.