From the RSNA refresher courses - Focused abdominal US for trauma

Focused abdominal ultrasonography (US) has been introduced in Europe as a m ethod to evaluate blunt abdominal trauma. The main focus of the examination is detection of free fluid in the abdomen secondary to injury of the abdom inal organs. The examination takes only a few minutes to perform. In the au thors' experience, trauma patients in unstable condition and in whom signif icant free fluid is detected are immediately taken to the operating room fo r surgical exploration without undergoing computed tomographic (CT) correla tion. The authors have also used US to identify the specific site of organ injury. Injuries to solid organs such as the liver, spleen, and kidney that are identified with US usually appear heterogeneous or hyperechoic. A hema toma surrounding the injured organ may appear echogenic or hypoechoic. Howe ver, pitfalls of focused abdominal US for trauma include failure to show co ntained solid-organ injuries; injuries to the diaphragm, pancreas, and adre nal gland; and some bowel injuries. Thus, negative findings at US do not ex clude an intraperitoneal injury, and close clinical observation or CT is wa rranted.