Question:easy
A patient presents with a left hypochondrium contusion with systolic blood pressure of 70 mmHg and pulse rate of 110 per minute. What should be done next?
A patient presents with a left hypochondrium contusion with systolic blood pressure of 70 mmHg and pulse rate of 110 per minute. What should be done next?
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In a haemodynamically unstable trauma patient, the bedside investigation of choice is rapid sonographic assessment of the abdomen.
Updated On: Jun 23, 2026
- FAST (Focused Assessment with Sonography in Trauma)
- CECT abdomen
- DPL (Diagnostic Peritoneal Lavage)
- Abdominal X-ray
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The Correct Option is A
Solution and Explanation
Trauma management -- haemodynamically unstable patient:
Clinical picture: Left hypochondrium trauma + SBP 70 mmHg + PR 110 bpm = haemodynamic instability. Suspect splenic laceration or left-sided hollow viscus injury with haemoperitoneum.
FAST scan overview:
- Focused Assessment with Sonography for Trauma
- Rapid, non-invasive, bedside, no radiation, no contrast
- Completed in $<5$ minutes
- Detects free fluid (haemoperitoneum) in Morrison's pouch, splenorenal recess, pelvis (pouch of Douglas), and pericardium
- In unstable patient with positive FAST: proceed directly to emergency laparotomy
Comparison of investigation options:
- FAST: Preferred first-line -- fast, bedside, safe in instability
- CECT: Gold standard for stable patients, contraindicated in instability (delays definitive care)
- DPL: Invasive, superseded by FAST; used when FAST unavailable/indeterminate
- Abdominal X-ray: Cannot detect haemoperitoneum; not appropriate
\[\boxed{\text{Answer: A -- FAST}}\]
Clinical picture: Left hypochondrium trauma + SBP 70 mmHg + PR 110 bpm = haemodynamic instability. Suspect splenic laceration or left-sided hollow viscus injury with haemoperitoneum.
FAST scan overview:
- Focused Assessment with Sonography for Trauma
- Rapid, non-invasive, bedside, no radiation, no contrast
- Completed in $<5$ minutes
- Detects free fluid (haemoperitoneum) in Morrison's pouch, splenorenal recess, pelvis (pouch of Douglas), and pericardium
- In unstable patient with positive FAST: proceed directly to emergency laparotomy
Comparison of investigation options:
- FAST: Preferred first-line -- fast, bedside, safe in instability
- CECT: Gold standard for stable patients, contraindicated in instability (delays definitive care)
- DPL: Invasive, superseded by FAST; used when FAST unavailable/indeterminate
- Abdominal X-ray: Cannot detect haemoperitoneum; not appropriate
\[\boxed{\text{Answer: A -- FAST}}\]
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