Focused assessment with sonography in trauma: experience of Al Jalla Hospital, Benghazi, Libya

Othman H. Tajoury; Mohamed O. Benkhdoura; Hanan Al-Enezi; Ahmed Denaly; Amna Elkoom

doi:10.18203/2349-2902.isj20242115

Authors

Othman H. Tajoury Department of Surgery, Libyan International Medical University, Benghazi, Libya
Mohamed O. Benkhdoura Department of Surgery, Benghazi University, Benghazi, Libya
Hanan Al-Enezi Department of Radiology, Benghazi University, Benghazi, Libya
Ahmed Denaly Department of Surgery, Al Jalla Hospital, Benghazi, Libya
Amna Elkoom Department of Surgery, Al Jalla Hospital, Benghazi, Libya

DOI:

https://doi.org/10.18203/2349-2902.isj20242115

Keywords:

Fast, Diagnostic tool, Intra-abdominal injuries, Predictive value of tests, Trauma, Ultrasonography

Abstract

Background: Focused assessment with sonography in trauma (FAST) is a commonly used tool in the diagnosis of trauma. The objective of this study is to compare the positive predictive value (PPV) and negative predictive value (NPV) of (FAST) and abdominal-pelvic computed tomography scans (CTAP) in cases of blunt abdominal injury, as well as to assess the need for abdominal surgery. The aims to investigate if any false negative ultrasound studies were associated with significant morbidity. The findings are also compared with previous studies.

Methods: The data collected from the registry records of Al Jalla hospital over a two-year period from January 1, 2022, to December 31, 2023. Data on sonographic findings, computed tomography findings, and patient outcomes were collected. Diagnostic characteristics, including predictive values, were calculated.

Results: A total of 220 patients were included.190 patients underwent FAST, with 25 (13%) showing positive results. Among 90 patients who underwent CTAP, 18 (20%) showed abnormalities, and 10 (5.3%) patients required surgery. When comparing FAST to CTAP in detecting abnormalities, the PPV and NPV were 0.625 and 0.857, respectively. When comparing FAST to the need for surgery, the PPV and NPV were 0.217 and 0.977, respectively. 4 patients (0.98%) had negative FAST results but still required surgery. No significant adverse outcomes or surgical interventions were observed in patients with normal vital signs, normal initial physical examination, and negative FAST findings who did not undergo CTAP.

Conclusions: In patients with an initially normal physical examination and negative FAST results, emergent CTAP may be avoided.

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