FAST usually includes US of the right upper quadrant, including the hepatorenal fossa, the left upper quadrant, including the perisplenic region; the right and left paracolic gutters, and the pelvis, performed to detect free fluid.
Regarding the sites, 16/29 patients showed fluid in the pelvis and rest in the perihepatic, perisplenic, right paracolic gutter and perinephric spaces.
Table A: US Scoring of Hemoperitoneum LOCATION THICKNESS OF FLUID POINTS Morison's Pouch >2cm 2 <2cm 1 Douglas Pouch >2cm 2 <2cm 1 Perisplenic space + 1 Paracolic gutter + 1 Floating bowel loops + 2 Table B1: MSCT Scoring of Hemoperitoneum Description Estimates Approximate amount Fluid in only one space Small 100-200 ml Fluid in two or more spaces.
The ultra sound revealed free fluid in sub hepatic space and right paracolic gutters
4) Intraperitoneal spread is favored by intestinal peristalsis, negative hydrostatic pressure below the diaphragm, and the passage of exfoliated tumor cells that follow the intra-abdominal fluid stream passing along the paracolic gutters
toward the diaphragm.
They were then moved cranially to the ipsilateral paracolic gutters, just below the iliac crests, through retroperitoneal tunnels.
In the case of cervical cancer, the ovaries are moved to the paracolic gutters.
There was also severe bleeding from the perisplenic area, lesser sac, both the paracolic gutters
1), free fluid in the right and left subphrenic spaces tracking down both paracolic gutters
into the pelvis.
This is followed by accumulation of ascites in Sub hepatic location in 86 cases (86%), in Morrison's Pouch in 85 cases (85%), in Paracolic gutters in 78 cases (78%) in Pelvis in 64 cases (64%).
Ascites was seen more commonly in subdiaphragmatic location in 89 cases (89%) Sub hepatic in 86 cases (86%), Morrison's Pouch in 85 cases (85%), Paracolic gutter in 78 cases (78%), Pelvis in 64 cases (64%), Lesser sac in 11cases (11%), Interloop in 15 cases (15%).
Liver, spleen, undersurface of diaphragm, paracolic gutters
, omentum, paraaortic region and pouch of douglas were visualized and explored to see any metastatic deposits all were found free of any metastasis.