Question

Left hypochondrium contusion SBP- 70 mm Hg PR 110. So what needs to be done next?

• A. FAST
• B. CECT
• C. DPL
• D. Abdomen X-ray

Answer 1

The Correct Option is A

A 70 mm Hg systolic blood pressure (SBP) with a heart rate (PR) of 110 suggests the patient is in hypovolemic shock, likely due to internal bleeding. The contusion in the left hypochondrium raises concern for splenic injury, which is common after blunt abdominal trauma. The next step in management is to rapidly assess for intra-abdominal bleeding. In such scenarios, a Focused Assessment with Sonography for Trauma (FAST) is ideal. FAST is a quick, non-invasive ultrasound examination that identifies free fluid (blood) in the peritoneal cavity. This step is crucial for immediate surgical decision-making compared to other options:

• CECT (Contrast-Enhanced Computed Tomography) is more detailed but takes longer and may require stable hemodynamic status.
• DPL (Diagnostic Peritoneal Lavage) is invasive and less commonly used due to advancements in FAST.
• Abdomen X-ray provides limited information for free fluid detection.

Therefore, FAST should be performed next to promptly guide further treatment interventions.