PROGNOSTIC POSSIBILITIES OF SONOGRAPHIC EXAMINATION AT THE EARLY HOSPITAL STAGE IN PATIENTS WITH ABDOMINAL TRAUMA WITH SUSPECTED INTERNAL BLEEDING

Abstract

The article presents the findings of a study conducted to assess the efficacy and diagnostic value of ultrasound examination during the early hospitalization stage in patients with abdominal trauma and suspected internal bleeding. The research involved 39 patients who were urgently hospitalized due to traumatic abdominal injuries during 2023-2024. Sonographic evaluation was conducted following the FAST protocol (Focused Assessment with Sonography for Trauma). The degree of impairment of consciousness of the victims was assessed by the GCS (Glasgow Coma Scale). The severity of traumatic injuries was determined by the ISS (Injury Severity Score) scale, and the revised RTS (Revised Trauma Score) scale was used to determine the severity of the victim.
A statistically significant relationship was established between hemodynamic parameters (lower systolic pressure and increased heart rate) and a positive result of the Fast protocol examination compared to a negative one. The method was also found to be highly sensitive. In almost 100% of cases, a positive FAST result in combination with clinical symptoms (especially unstable hemodynamics) was an indication for abdominal surgery (pleural drainage, laparoscopy, diagnostic peritoneal lavage or laparotomy).
There was no significant correlation between the severity of traumatic injuries, the severity of the victim's condition (according to different scales − GCS, ISS, RTS) and FAST results, which can be explained by the presence of cranio-skeletal injuries in victims, which sonography is not sufficient to detect. A positive result of a sonographic examination using the FAST protocol in a hemodynamically unstable patient may indicate the need for immediate surgical intervention.