Unstable
FAST to search for free fluid (vs. DPL if unavailable)
Positive: Exploratory laparotomy
Negative: CT scan
Stable
CT scan
Exploratory laparotomy, angiographic embolization, conservative management as indicated
FAST to search for free fluid (vs. DPL if unavailable)
Positive: Exploratory laparotomy
Negative: CT scan
Positive: Exploratory laparotomy
Negative: CT scan
CT scan
Exploratory laparotomy, angiographic embolization, conservative management as indicated
Exploratory laparotomy, angiographic embolization, conservative management as indicated
Ultrasound (FAST)
Indicated only for hemodynamically unstable trauma patients
Otherwise CT is indicated for primary imaging
Ultrasound cannot reliably evaluate retroperitoneum / hollow viscous injury
Ultrasound has lower sensitivity in the setting of pelvic fractures
If CT is not available (e.g. low resource area, multiple casualty) can consider serial FAST exams, which increases sensitivity
For example, serial<unk>  exams with two FAST examinations performed at least 6 hours apart
CT
CT with IV contrast only is typical standard
May consider triple-contrast (IV, PO, PR) if specific concern for viscous perforation, although delay to imaging typically prohibits this as the initial study
Indicated only for hemodynamically unstable trauma patients
Otherwise CT is indicated for primary imaging
Ultrasound cannot reliably evaluate retroperitoneum / hollow viscous injury
Ultrasound has lower sensitivity in the setting of pelvic fractures
If CT is not available (e.g. low resource area, multiple casualty) can consider serial FAST exams, which increases sensitivity
For example, serial<unk>  exams with two FAST examinations performed at least 6 hours apart
Otherwise CT is indicated for primary imaging
Ultrasound cannot reliably evaluate retroperitoneum / hollow viscous injury
Ultrasound has lower sensitivity in the setting of pelvic fractures
If CT is not available (e.g. low resource area, multiple casualty) can consider serial FAST exams, which increases sensitivity
For example, serial<unk>  exams with two FAST examinations performed at least 6 hours apart
Ultrasound cannot reliably evaluate retroperitoneum / hollow viscous injury
Ultrasound has lower sensitivity in the setting of pelvic fractures
For example, serial<unk>  exams with two FAST examinations performed at least 6 hours apart
CT with IV contrast only is typical standard
May consider triple-contrast (IV, PO, PR) if specific concern for viscous perforation, although delay to imaging typically prohibits this as the initial study
May consider triple-contrast (IV, PO, PR) if specific concern for viscous perforation, although delay to imaging typically prohibits this as the initial study
Abdominal trauma
Diaphragmatic trauma
Splenic trauma
Liver trauma
G-tube complications
Bladder trauma
Pelvic fractures
Genitourinary trauma