EARLY DETECTION OF HEMOPERITONEUM BY ULTRASOUND EXAMINATION OF THE RIGHT UPPER QUADRANT - A MULTICENTER STUDY

Background: The focused assessment for the sonographic examination of the trauma patient (FAST) is a rapid diagnostic test that sequentially surveys for hemopericardium and then the right upper quadrant (RUQ), left upper quadrant (LUQ), and pelvis for hemoperitoneum in patients w ith potential truncal injuries. The sequence of the abdominal part of the examination, however, has Set to be validated. The objectives of t his multicenter study were as follows: (1) to determine where hemoperi toneum is most frequently identified on positive FAST examinations; an d (2) to determine if a relationship exists between that areas and the organs injured. Methods: Ultrasound registries from four Level I trau ma centers identified patients who had true-positive FAST examinations , Demographic data, areas positive on the FAST, and organs injured wer e recorded; injuries were classified as multiple, single solid organ ( liver or spleen), isolated hollow viscus, or retroperitoneal. Relation ships between positive locations on the FAST examinations and the asso ciations of organs injured to areas positive were assessed using McNam ara's chi(2) test; a p value < 0.05 was considered statistically signi ficant. Results: The RUQ was the most common site where hemoperitoneum was detected, and this was statistically significant compared with ei ther the LUQ or the pelvis, Also, statistically significant correlatio ns (p < 0.001) were observed between positive RUQ areas on the FAST an d multiple injuries, single solid organ (liver or spleen) injury, and retroperitoneal injuries, Conclusion: Blood is most often found on the FAST in the RUQ area in patients with multiple intraperitoneal injuri es or isolated injury to the liver, spleen, or retroperitoneum, but no t when there is injury to a hollow viscus.