Brenkert Timothy E, Adams Cynthia, Vieira Rebecca L, Rempell Rachel G
Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
Am J Emerg Med. 2017 Oct;35(10):1497-1499. doi: 10.1016/j.ajem.2017.04.025. Epub 2017 Apr 14.
To determine the location of intraperitoneal free fluid on FAST exam in pediatric patients undergoing evaluation for trauma.
Retrospective review of all FAST exams positive for intraperitoneal free fluid performed in patients sustaining trauma between August 2009 and February 2016 in an urban pediatric emergency department. Positive results were categorized into one of nine potential intraperitoneal locations; 4 each in the right and left upper quadrants, and the pelvis.
One hundred and three complete positive studies were reviewed. The median age of patients was 10years (IQR 7-14) with 66% being male. Ninety-five percent had fluid present in the pelvis, 35% had fluid present in the RUQ, and 16.5% had fluid present in the LUQ. Overall, the most frequent location of fluid outside of the pelvis was found at the inferior tip of the liver, present in 83.3% of patients with fluid in the RUQ and 29% of all patients with a positive FAST.
The majority of pediatric trauma patients with a positive FAST exam will exhibit free fluid in the pelvis. Particular attention should be directed to the inferior tip of the liver in children as this represents the most common location for fluid collection outside the pelvis.
确定在接受创伤评估的儿科患者中，通过FAST检查确定腹腔内游离液体的位置。
回顾性分析2009年8月至2016年2月在一家城市儿科急诊科对创伤患者进行的所有腹腔内游离液体FAST检查阳性结果。阳性结果分为九个潜在腹腔位置之一；右上腹和左上腹各4个，以及盆腔。
回顾了103项完整的阳性研究。患者的中位年龄为10岁（四分位间距7 - 14岁），66%为男性。95%的患者盆腔有液体，35%的患者右上腹有液体，16.5%的患者左上腹有液体。总体而言，盆腔外最常见的液体位置位于肝下缘，在83.3%的右上腹有液体的患者和29%的所有FAST检查阳性的患者中存在。
大多数FAST检查阳性的儿科创伤患者盆腔会出现游离液体。儿童应特别注意肝下缘，因为这是盆腔外液体聚集最常见的位置。
