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Chapter 9 - Point-of-Care Abdominal Ultrasound

Published online by Cambridge University Press:  28 April 2020

By
Shaun L. Thompson  and
Daniel W. Johnson
Edited by
Andrew B. Leibowitz  and
Suzan Uysal
Andrew B. Leibowitz
Affiliation:
Icahn School of Medicine at Mount Sinai
Suzan Uysal
Affiliation:
Icahn School of Medicine at Mount Sinai
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Summary

Abdominal ultrasonography is an extremely valuable diagnostic tool for all perioperative physicians. While the FAST exam was designed for use in patients with blunt abdominal trauma, its principles are applicable in a wide variety of perioperative settings and can be used to narrow the differential diagnosis in unstable patients. Aortic ultrasound is easy to perform and rapidly confirms or rules out the presence of abdominal aortic aneurysm or dissection. Other uses include gallbladder imaging and evaluation for free intra-peritoneal air. Perioperative and intensive care unit patients will benefit from point-of-care ultrasound, including detailed examination of the abdominal cavity.

Keywords

Abdominal ultrasoundFAST examaortic ultrasoundgallbladder ultrasoundpoint-of-care ultrasoundcritical care
Type
Chapter
Information
Modern Monitoring in Anesthesiology and Perioperative Care , pp. 92 - 99
Publisher: Cambridge University Press
Print publication year: 2020

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References

Kameda, T, Taniguchi, N. Overview of point-of-care abdominal ultrasound in emergency and critical care. J Intensive Care 2016;4:53.Google Scholar
Pace, J, Arntfield, R. Focused assessment with sonography in trauma: a review of concepts and considerations for anesthesiology. Can J Anaesth 2018;65:360–70.Google Scholar
American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med 2014;33:2047–56.Google Scholar
McGahan, JP, Rose, J, Coates, TL, Wisner DH, Newberry P. Use of ultrasonography in the patient with acute abdominal trauma. J Ultrasound Med 1997;12:653–62.Google Scholar
Laing, F, Federle, M, Jeffery, B, Brown TW. Ultrasonic evaluation of patients with acute right upper quadrant pain. Radiology 1981;140:449.CrossRefGoogle ScholarPubMed
Savatmongkorngul, S, Wongwaisayawan, S, Kaewlai, R. Focused assessment with sonography for trauma: current perspectives. Open Access Emergency Medicine 2017;9:57–62.Google Scholar
Elbaih, AH, Abu-Elela, ST. Predictive value of focused assessment with sonography for trauma (FAST) for laparotomy in unstable polytrauma Egyptian patients. Chin J of Traumatol 2017;20:323–28.CrossRefGoogle Scholar
Sheng, AY, Dalziel, P, Liteplo, AS, Fagenholz P, Noble VE. Focused assessment with sonography in trauma and abdominal computed tomography utilization in adult trauma patients: trends over the last decade. Emerg Med Int 2013;2013:678380.Google Scholar
Montoya, J, Stawicki, SP, Evans, DC, et al. From FAST to E-FAST: an overview of the evolution of ultrasound-based traumatic injury assessment. Eur J Trauma Surg 2016;42:119–26.Google ScholarPubMed
Ollerton, JE, Sugrue, M, Balogh, Z, et al. Prospective study to evaluate the influence of FAST on trauma patient management. J Trauma 2006;60:785–91.Google Scholar
Jehle, D, Guarino, J, Karamanoukian, H. Emergency department ultrasound in the evaluation of blunt abdominal trauma. Am J Emerg Med 1993;11(4):342–6.Google Scholar
Moore, CL, Copel, JA. Point-of-care ultrasonography. N Engl J Med. 2011;364:749–57.CrossRefGoogle ScholarPubMed
Noble, VE. Think ultrasound when evaluating for pneumothorax. J Ultrasound Med 2012;31(3):501–4.Google Scholar
Dammers, D, El Moumni, M, Hoogland, II, Veeger, N, Ter Avest, E. Should we perform a FAST exam in haemodynamically stable patients presenting after blunt abdominal injury: a retrospective cohort study. Scand J Trauma Resusc Emerg Med 2017;25:1.Google Scholar
Melniker, LA, Leibner, E, McKenney, MG, et al. Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial. Ann Emerg Med 2006;48:227–35.Google Scholar
Boulanger, BR, McLellan, BA, Brenneman, FD, Ochoa, J, Kirkpatrick, AW. Prospective evidence of the superiority of a sonography-based algorithm in the assessment of blunt abdominal injury. J Trauma 1999;47:632–7.CrossRefGoogle ScholarPubMed
Arrillaga, A, Graham, R, York, JW, Miller, RS. Increased efficiency and cost-effectiveness in the evaluation of the blunt abdominal trauma patient with the use of ultrasound. Am Surg 1999;65:31–5.Google ScholarPubMed
Rozycki, GS, Newman, PG. Surgeon-performed ultrasound for the assessment of abdominal injuries. Adv Surg 1999;33:243–59.Google ScholarPubMed
Rozycki, GS, Ballard, RB, Feliciano, DV, Schmidt, JA, Pennington SD. Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann Surg 1998;228:557–67.CrossRefGoogle ScholarPubMed
Jehle, D, Stiller, G, Wagner, D. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med 2003;21:476–8.Google Scholar
O’Brien, KM, Stolz, LA, Amini, R, et al. Focused assessment with sonography for trauma examination: re-examining the importance of the left upper quadrant view. J Ultrasound Med 2015;34:1429–34.Google Scholar
Boniface, KS, Calabrese, KY. Intensive care ultrasound: IV. Abdominal Ultrasound in Critical Care. Ann Am Thorac Soc 2013;10:713–24.Google ScholarPubMed
Lobo, V, Hunter-Behrend, M, Cullnan, E, et al. Caudal edge of the liver in the right upper quadrant (RUQ) view is the most sensitive area for free fluid on the FAST exam. West J Emerg Med 2017;18:270–80.Google Scholar
Abrams, BJ, Sukumvanich, P, Seibel, R, Moscati, R, Jehle, D. Ultrasound for the detection of intraperitoneal fluid: the role of Trendelenberg positioning. Am J Emerg Med 1999;17:117–20.CrossRefGoogle Scholar
Ma, OJ, Kefer, MP, Mateer, JR, Thoma, B. Evaluation of hemoperitoneum using a single-view vs multiple-view ultrasonographic examination. Acad Emerg Med 1995;2:581–6.Google Scholar
Rozycki, G, Ochsner, M, Feliciano, D, et al. Early detection of hemoperitoneum by ultrasound examination of the right upper quadrant: a multicenter study. J Trauma 1998;45:878–83.Google Scholar
Blackbourne, LH, Soffer, D, McKenney, M, et al. Secondary ultrasound examination increases the sensitivity of the FAST exam in blunt trauma. J Trauma 2004;57:934–8.CrossRefGoogle ScholarPubMed
Blanco, P, Volpicelli, G. Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians. Crit Ultrasound J 2016;8:15.Google Scholar
Sosland, RP, Gupta, K. McConnell’s sign. Circulation 2008;118:e517–e518.Google Scholar
McConnell, MV, Solomon, SD, Rayan, ME, et al. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996;78:469–73.Google Scholar
Airapetian, N, Maizel, J, Alyamani, O, et al. Does inferior vena cava respiratory variability predict fluid responsiveness in spontaneously breathing patients? Crit Care 2015;19:400.Google Scholar
Tayal, VS, Nielsen, A, Jones, AE, et al. Accuracy of trauma ultrasound in major pelvic injury. J Trauma 2006;61:1453–57.Google Scholar
Gaarder, C, Kroepelien, CF, Loekke, R, et al. Ultrasound performed by radiologists-confirming the truth about FAST in trauma. J Trauma 2009;67:323–27.Google ScholarPubMed
Chenkin, J. Diagnosis of aortic dissection presenting as ST-elevation myocardial infarction using point-of-care ultrasound. J Emerg Med 2017;53:880–4.Google Scholar
Hartshorne, TC, McCollum, CN, Earnshaw, JJ, Morris, J, Nasim, A. Ultrasound measurement of aortic diameter in a national screening programme. Eur J Vasc Endovasc Surg 2011;42:195–9.Google Scholar
Thapar, A, Cheal, D, Hopkins, T, et al. Internal or external wall diameter for abdominal aortic aneurysm screening? Ann R Coll Surg Engl 2010;92(6):503–5.CrossRefGoogle ScholarPubMed
Ellis, M, Powell, JT, Greenhalgh, RM. Limitations of ultrasonography in surveillance of small abdominal aortic aneurysms. Br J Surg 1991;78(5):614–6.Google Scholar
Pare, JR, Liu, R, Moore, CL, et al. Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection. Am J Emerg Med 2016;34:486–92.Google Scholar

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