الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This i s a prospective study, 50 patients presented to the ER of Menofia university hospital with blunt abdominal trauma underwent ultrasonography & FAST examination at the time of presentation & Follow up Ultrasonography after 12& 24 hour except 12 cases were hemodynamically unstable 6 cases from them had sever intra- abdominal hemorrhage & entered the OR (operation room) urgently after FAST examination and the Other 6 cases entered the ICU for urgent care, FAST findings& Follow up Ultrasonography findings were correlated with patients clinical data. The most affected age are the 2-10 years old group.Car accident represents the most common cause (70%) and more common in male (48%). Ultrasonography is considered the best modality in initial evaluation of blunt abdominal trauma patients as it is readily available, requires minimal preparation time, not invasive and may be performed with mobile equipment that allows greater flexibility in patient positioning. However, ultrasound examination is operator dependent, Lacerations of solid organs can be overlooked, injuries of the dome or lateral segment of the liver can be overlooked, especially in the presence of ileus or an uncooperative patient. Moreover, hepatic lacerations or hematomas may be difficult to detect, especially in the acute phase, when they are isoechoic to the normal liver. Pancreatic & gastrointestinal injures are difficult to be seen by ultrasonography, however presence of inta-abdominal fluid (positive FAST) suggests intra-abdominal injury, CECT should be performed.
Ultrasonography is very useful in follow up of patients with minor intra-abdominal injury & decreases use of CT which has the disadvantages of being expensive, high dose radiation, contrast agent use & not available in all hospitals. Repeated ultrasonography in patients of blunt abdominal trauma & close clinical observation increases the sensitivity of ultrasonography for intra-abdominal bleeding to nearly 100% & nearly no patient with intra-abdominal injury could be missed, as in some cases of intra-abdominal injury, there is minimal bleeding that it give negative FAST on initial examination.
In cases of positive FAST scan, the patient should not be operated on until the exact site of intra-abdominal injury is detected by ultrasonography o unless the patient was hemodynamically unstable, as in some cases the intra- abdominal fluid could be ascites due to disease as liver failure, that repeated ultrasonography & close clinical observation of the patient help to avoid unnecessary labarotomy.