A diagnostic negative ultrasound finding in blunt abdominal trauma

Fikri M. Abu-Zidan, Husni S. Shalak, Mohammed A. Alhaddad

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Ultrasound is an extension of the clinical examination and its findings should be correlated with the clinical picture as a whole to be useful. Hereby, we report a unique negative diagnostic ultrasound finding in blunt abdominal trauma which was not reported before. Clinical presentation: A 50-year-old obese man presented complaining of severe generalized abdominal pain and inability to pass urine of three days duration after he slipped on his abdomen. The abdomen was distended and tender all over. There was no blood on the urethral meatus. FAST scan showed significant intra-peritoneal fluid. The urinary bladder could not be seen. A Foley catheter was inserted which drained 3 L of clear urine. The abdominal distention became less. Repeated FAST scan was completely negative. A clinical diagnosis of major intra-peritoneal rupture of the urinary bladder was made. Trauma CT scan and laparotomy confirmed the diagnosis. Conclusions: The change of a positive FAST to a negative FAST was diagnostic of a major intra-peritoneal urinary bladder rupture even before performing a trauma CT scan. When performing FAST in blunt abdominal trauma, it is more useful to perform FAST before inserting a urinary catheter and it is advised to repeat it.

Original languageEnglish
Pages (from-to)125-127
Number of pages3
JournalTurkish Journal of Emergency Medicine
Volume18
Issue number3
DOIs
Publication statusPublished - Sep 2018

Keywords

  • Injury
  • Rupture
  • Trauma
  • Ultrasound
  • Urinary bladder

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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