Early diagnosis of damage to internal organs in thoracoabdominal injuries

Background. Thoracoabdominal wounds in combat occupy a key place and often become the cause of mortality. Early pre-hospital diagnosis plays an important role in triage according to the degree of severity of injuries, further selection of research methods and treatment strategy. Objective: to evaluate the possibilities of ultrasonography using the FAST protocol in the early diagnosis of damage to internal organs in thoracoabdominal injuries. Materials and methods. The results of ultrasonography using the FAST protocol were analyzed in the diagnosis of gunshot thoracoabdominal injuries in 57 victims. Diagnosis was carried out using linear and convex sensors in the frequency range of 5–10 and 2–5 MHz on the Ultima Radmir device. Results. According to computed tomography scans, 113 thoracoabdominal injuries were found in 57 wounded patients. On ultrasound, signs of damage to the thoracoabdominal organs were detected in 96 (84.9 %) patients using the FAST protocol: free gas in the abdominal cavity — in 13 (11.5 %), free fluid — in 29 (25.7 %), pericardial effusion — in 12 (10.6 %), free fluid in the pleural sinus — in 19 (16.8 %), pneumothorax — in 25 (22.1 %) cases, respectively. Conclusions. Ultrasonography using the FAST protocol allows you to detect signs of damage to internal organs in thoracoabdominal injuries. When detecting free gas and liquid, the sensitivity of ultrasound using the FAST protocol was 91.4 %, specificity — 75.0 %, accuracy — 90.3 %, positive predictive value — 98.0 %, negative predictive value — 49.0 %.