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What is A child presented with blunt abdominal trauma, the first investigation to be done is - and explain in detail?
Ans. is 'a' i.e., USG o The prime aim of investigations in a pt. of blunt trauma abdomen is to determine whether the patient needs an exploratory laparotomy or not.# Previously DPL was the inv. of choice to determine the presence of intra-abdominal hemorrhage, but currently Ultrasound has replaced DPI.# U/S is the investigation of choice in both stable as well as unstable patients.Schwartz writes- "Blunt abdominal trauma initially is evaluated by FAST examination in most major trauma centers, and this has largely supplanted DPL. FAST is not 100% sensitive, however, so diagnostic peritoneal aspiration is still advocated in hemodynamically unstable patients without a defined source of blood loss to rule out abdominal hemorrhage. Patients with fluid on FAST examination, considered a 'positive FAST', who do not have immediate indications for laparotomy and are hemodynamically stable undergo CT scanning to quantify their injuries."