Ultrasound in Pediatric Emergencies

Gaurav Saigal, MD, Jennifer Runco Therrien, MD, and Frank Kuo, BS


Appl Radiol. 2014;43(8) 

In This Article

Traumatic Pathology

Focused assessment with sonography for trauma (FAST) is a rapidly performed bedside study to identify ectopic abdominal fluid. The four locations typically examined for free fluid include the right upper quadrant (perihepatic space or the Morison's pouch), the left upper quadrant (perisplenic space), the pericardium and the pelvis. A positive FAST is defined as the presence of fluid, seen as an anechoic volume in dependent regions of the peritoneal cavity (Figure 1). For an unstable patient with blunt trauma, the speed and cost of ultrasound (US) are significantly better than either diagnostic peritoneal lavage or CT. In addition, including US for trauma in the ED results in decreased time to operative care and more efficient utilization of ED resources.[1]

Figure 1.

A 3-year-old, status post MVA. FAST ultrasound demonstrates the presence of free fluid (white arrows) in the pelvis (A) and the left upper quadrant, surrounding the spleen (B). Axial CT scan of the abdomen (C) demonstrates a splenic laceration (black arrow).