{"id":1664,"date":"2020-07-29T08:00:00","date_gmt":"2020-07-29T08:00:00","guid":{"rendered":"http:\/\/emultrasound.sdsc.edu\/?p=1664"},"modified":"2021-05-04T16:55:22","modified_gmt":"2021-05-04T16:55:22","slug":"caudal-edge-of-liver-fast","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/07\/29\/caudal-edge-of-liver-fast\/","title":{"rendered":"Caudal Edge of the Liver in the Right Upper Quadrant (RUQ) View Is the Most Sensitive Area for Free Fluid on the FAST Exam"},"content":{"rendered":"
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Background<\/h2>\n

The FAST exam is a useful tool in screening for the presence of intraperitoneal free fluid in the setting of trauma. The utilization of ultrasound provides rapid imaging in the trauma bay that can help guide clinical decision making and the necessity for surgical intervention. The FAST exam is comprised of subxiphoid, right upper quadrant, left upper quadrant, and suprapubic views by ultrasound. Previous research has indicated that the RUQ, specifically the hepato-renal space (Morrison’s pouch), is the preferred area for the detection of free fluid.<\/span>1,2<\/span><\/span> However, scarce research into the sub-divisions of each view has been performed. <\/span><\/p>\n

Caudal Edge of the Liver in the Right Upper Quadrant (RUQ) View Is the Most Sensitive Area for Free Fluid on the FAST Exam<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Clinical Question<\/h3>
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The aim of this study was to determine what specific sub-divided areas of each FAST view were the most sensitive in the detection of intraperitoneal free fluid.\u00a0<\/span><\/p>\n<\/div><\/div>\n

Methods & Study Design<\/h3>
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\u2022 Design\u00a0<\/b><\/span><\/p>\n

This was a retrospective cohort analysis.\u00a0<\/span><\/p>\n

\u2022 Population\u00a0<\/b><\/span><\/p>\n

All patients who received a FAST exam at a single Level 1 trauma center over an 18-month period.<\/span><\/p>\n

\u2022 Intervention\u00a0<\/b><\/span><\/p>\n

The RUQ, LUQ, and suprapubic views of the FAST were each subdivided into three additional sections for analysis. Specifically, the RUQ was divided into the hepato-diaphragmatic space (RUQ1), hepato-renal space (Morrison\u2019s pouch) (RUQ2), and the caudal liver tip (RUQ3). The LUQ was divided into the spleno-diaphragmatic space (LUQ1), the spleno-renal space (LUQ2), and the inferior pole of the kidney (LUQ3). The suprapubic area was divided into the lateral sides of the bladder (SP1), posterior bladder and anterior pelvic organ space (SP2), and posterior uterus (in female subjects) (SP3). The subxiphoid view was excluded as the study was only interested in intraperitoneal free fluid.\u00a0\u00a0<\/span><\/p>\n

\u2022 Outcomes\u00a0\u00a0<\/b><\/span><\/p>\n

Each sub-quadrant of all positive FAST exams was analyzed for the presence of free fluid.\u00a0<\/span><\/p>\n<\/div><\/div>\n

Results<\/h3>
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