Role of Ultrasound in Abdominal Trauma on General Surgery

The main cause of death in traumas is hypovolemic shock. Regardless computed tomography is the gold standard in hemodynamically unstable patients ultrasound can be a rapid, reproducible, portable, and noninvasive method such as ultrasound emerged, directed for detecting hemopericardium, hemoperitoneum, and hemopneumothorax, in a "point of care" modality, known as the focused assessment with sonography for trauma (FAST) protocol. Also, is performed in stable patients as a first option in trauma algorism. Is a simple approach performed in 2-3min evaluating four regions to be examined in the traditional FAST protocol: pericardium (to detect cardiac tamponade), right upper abdominal quadrant, left upper abdominal quadrant, and pelvis (to detect hemoperitoneum). The called extended FAST (e-FAST) protocol also searches the pleural spaces for hemothorax and pneumothorax. Also, in a specific exploration in stable patients, it can be useful to explore visceral damage in solid organs such as the liver, spleen or kidney. FAST/e-FAST protocol is designed to provide a simple "yes or no" answer regarding the presence of bleeding. We don´t use the FAST protocol to estimate the quantity of free liquid in the abdominal cavity but is used to determine the presence or not. CT should be considered for hemodynamically stable patients.