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The Focused Abdominal Sonography for Trauma Scan

Pearls and Pitfalls

Department of Radiology (J.P.M., M.G.) and Division of Emergency Medicine (J.R.), University of California Davis Medical Center, Sacramento, California.

Address correspondence and reprint requests to John P. McGahan, MD, Department of Radiology, University of California Davis Medical Center, School of Medicine, 4860 Y St, Suite 3100, Sacramento, CA 95817.

Objective. To review the state-of-the-art use of sonography in evaluating the patient with trauma. Methods. We reviewed our experience in performing more than 5000 sonographic examinations in the patient with trauma. The recent experience of other publications advocating newer applications of sonography in the patient with trauma are discussed and presented in a pictorial fashion. Results. The main focus of sonography in the patient with trauma has been in performance of the focused abdominal sonography for trauma scan. The focused abdominal sonography for trauma scan is usually performed in the patient with blunt abdominal trauma and is used to check for free fluid in the abdomen or pelvis. There are certain pitfalls that need to be avoided and certain limitations of the focused abdominal sonography for trauma scan that need to be recognized. These pitfalls and limitations are reviewed. More recently, sonography has been used to detect certain solid-organ injuries that have a variety of appearances. Thus, sonography may be used to localize the specific site of injury in these patients. More recently, sonography has been used to evaluate thoracic abnormalities in patients with trauma, including pleural effusions, pneumothoraces, and pericardial effusions. Conclusions. The use of sonography in evaluating the patient with trauma has rapidly expanded in the past decade. Those using sonography in this group of patients should be aware of its many uses but also its potential pitfalls and limitations.

Key Words: abdominal parenchymal injury • abdominal sonography • focused abdominal sonography for trauma • Morison pouch • pitfalls

Abbreviations: BAT, blunt abdominal trauma • CT, computed tomography • FAST, focused abdominal sonography for trauma • IAI, intra-abdominal injury

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