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The Utility of Sonography for the Triage of Blunt Abdominal Trauma Patients to Exploratory Laparotomy

Brett C. Lee1, Eleanor L. Ormsby1, John P. McGahan1, Giselle M. Melendres1 and John R. Richards2

1 Department of Radiology, University of California Davis School of Medicine and University of California Davis Medical Center, 4860 Y St., Ste. 3100, Sacramento, CA 95817.
2 Department of Emergency Medicine, University of California Davis School of Medicine and University of California Davis Medical Center, Sacramento, CA.


Figure 1
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  		Fig. 1 —37-year-old hypotensive man being evaluated after motor vehicle collision with only finding of small right upper quadrant fluid on focused abdominal sonography for trauma (FAST). Patient was taken emergently to laparotomy and underwent hemostasis of liver laceration and repair of colon serosal tears.

 

Figure 2
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  		Fig. 2A —44-year-old man being evaluated after motor vehicle collision. Focused abdominal sonography for trauma (FAST) image (A) and CT image (B) show moderate amount of pelvic free fluid (FF, A) adjacent to bladder (B, A). Patient underwent exploratory laparotomy for hemostasis of liver laceration.

 

Figure 3
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  		Fig. 2B —44-year-old man being evaluated after motor vehicle collision. Focused abdominal sonography for trauma (FAST) image (A) and CT image (B) show moderate amount of pelvic free fluid (FF, A) adjacent to bladder (B, A). Patient underwent exploratory laparotomy for hemostasis of liver laceration.

 

Figure 4
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  		Fig. 3 —26-year-old woman with hypotension being evaluated after assault. Scan of left lower quadrant shows large amount of complex fluid/hematocrit level with layering echogenic blood (arrows). Patient was taken emergently for exploratory laparotomy and found to have ruptured spleen requiring splenectomy.

 

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