The Role of Focused Assessment with Sonography for Trauma (FAST) in Children with Stable Hemodynamics after Blunt Abdominal Trauma:the Spleen and Hepatic Rupture Case Series

M. Muamar, Suwardi .
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Abstract

Introduction: The most prevalent type of abdominal trauma in children is blunt abdominal trauma (BAT). Traffic accidents and falls are the most prevalent causes of trauma. In this case, a CT scan is the gold standard for detecting BAT. However, there are several limits to this examination, particularly in terms of availability, cost, and radiation exposure. In BAT, FAST assists in the detection of intraabdominal free fluid. Case Description: Three pediatric patients with stable hemodynamics underwent BAT in this case series. All three patients were below 17 years old and had stomach discomfort due to a traffic accident. All three patients tested positive for FAST. Then, a contrast CT scan of the abdomen revealed a splenic rupture in the three patients and a splenic rupture and liver rupture in one of them. All the patients were hemodynamically stable before being treated with symptomatic medicines in a conservative (non-surgical) manner. All of the patients had satisfactory outcomes and could return home without undergoing surgery. Conclusion: Both FAST and CT scans do not affect therapeutic care, that were conservative management in these patients with stable hemodynamics. As a result, FAST may be a less expensive examination alternative, reducing radiation exposure and lowering the risk of cancer in children in the future.
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创伤超声聚焦评估(FAST)在钝性腹部创伤后血流动力学稳定的儿童中的作用:脾和肝破裂病例系列
儿童最常见的腹部创伤类型是钝性腹部创伤(BAT)。交通事故和跌倒是造成创伤最普遍的原因。在这种情况下,CT扫描是检测BAT的金标准。然而,这种检查有几个限制,特别是在可用性、成本和辐射暴露方面。在BAT中,FAST有助于检测腹内游离液。病例描述:本病例系列中有3例血流动力学稳定的儿童患者接受了BAT治疗。三名患者均未满17岁,因交通事故导致胃部不适。三名患者的FAST检测均呈阳性。然后,腹部对比CT扫描显示三名患者脾破裂,其中一名患者脾破裂并肝破裂。所有患者在接受对症药物保守(非手术)治疗前血流动力学稳定。所有患者均获得满意结果,无需手术即可返回家中。结论:对于血流动力学稳定的患者,FAST和CT扫描均不影响治疗护理,采取保守处理。因此,FAST可能是一种更便宜的检查选择,减少辐射暴露并降低未来儿童患癌症的风险。
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