Last reviewed: November 2017
Last updated: November  2017

Important updates

RCT casts doubt on value of focused abdominal sonography for trauma (FAST) in hemodynamically stable children with blunt torso trauma

  • A new RCT compared FAST with standard care in children and adolescents with blunt torso trauma.

  • Previous research found FAST may be useful in evaluation of children with blunt abdominal trauma who are hemodynamically unstable.

  • The new RCT raised uncertainty over the value of FAST for hemodynamically stable children and adolescents with blunt torso trauma. It found no significant difference in the proportion of abdominal CT scans, missed intra-abdominal injuries, length of stay in the emergency department, and median hospital costs in the children evaluated using FAST compared with those receiving standard care.

See Diagnosis: approach

Original source of update

Summary

Differentials

Common

  • Constipation
  • Acute appendicitis
  • Gastroenteritis
  • Urinary tract infection
  • Abdominal trauma (blunt or penetrating)
  • Cholelithiasis/cholecystitis
  • Primary dysmenorrhea
  • Pneumonia
  • Functional abdominal pain

Uncommon

  • Intussusception
  • Meckel diverticulum
  • Mesenteric adenitis
  • Hirschsprung disease
  • Ulcerative colitis
  • Crohn disease
  • Small bowel obstruction
  • Volvulus
  • Large bowel obstruction
  • Necrotizing enterocolitis
  • Peptic ulcer disease
  • Viral hepatitis
  • Biliary dyskinesia
  • Acute pancreatitis
  • Splenic infarction/cysts
  • Nephrolithiasis
  • Testicular torsion
  • Ovarian torsion
  • Ruptured ovarian cyst
  • Pelvic inflammatory disease
  • Pregnancy complications
  • Empyema

Contributors

Authors VIEW ALL

Professor

Department of Pediatric Surgery

McGovern Medical School at The University of Texas Health Science Center at Houston

Houston

TX

Disclosures

KT declares that he has no competing interests.

Resident and Pediatric Surgery Research Fellow

Department of Pediatric Surgery

McGovern Medical School at The University of Texas Health Science Center at Houston

Houston

Tx

Disclosures

KTA declares that she has no competing interests.

Dr KuoJen Tsao and Dr Kathryn Tinsley Anderson would like to gratefully acknowledge Dr Luke R. Putnam, Dr Shinil K. Shah, Dr Nathan D. Allison, and Dr Peter A. Walker, previous contributors to this monograph. LRP, SKS, NDA, and PAW declare that they have no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Pediatrics

Johns Hopkins School of Medicine

Baltimore

MD

Disclosures

AOS declares that she has no competing interests.

Professor of Surgery

University of Missouri

Kansas City Children's Mercy Hospital

Kansas City

MO

Disclosures

CLS declares that he has no competing interests.

Assistant Professor

Pediatric Gastroenterology and Nutrition

The Johns Hopkins Hospital

Baltimore

MD

Disclosures

KAY declares that she has no competing interests.

Consultant Paediatric Surgeon

Department of Paediatric Surgery

Birmingham Children's Hospital

Birmingham

UK

Disclosures

RGB declares that he has no competing interests.

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