Introduction: Trauma is one of the most common causes of death in the world. E-Fast ultrasound can detect the haemoperitoneum, intravenous pneumothorax, and hemothorax. In this study, we evaluated the accuracy of E-FAST focused ultrasound in blunt trauma patients referred to the Emergency Department. Methods: In this study 167 blunt trauma patients were included. E-FAST is performed from four standard spaces in terms of free fluid, chest in terms of hemothorax, and pneumothorax. Ultrasound is performed on the trauma patient and the obtained results were compared with the result of the standard gold CT scan test. All patient information including age, sex, mechanism of trauma, patient ISS, E-FAST result, and CT scan result were registered. Results: Overall, 174 patients were included that 45 (25.9%) of them were females. The mean age of the patients was 38.39±12.31 years. E-FAST had a sensitivity of 66.7 and a specificity of 100% in the diagnosis of hemothorax. Also, a positive predictive value of 100% and a negative predictive value of 99.4% were detected for 120 people in both normal tests. Conclusion: The results show E-FAST is a suitable alternative to CT scan in the diagnosis of hemothorax, pneumothorax, and free fluid in the abdomen, vulva, and pericardial cavity. Due to portability, safe body, no need for contrast, fast performance, as well as cheapness, and reproducibility, it will be a great help in diagnosing trauma-related lesions and prompt and timely treatment. CT scan should be used only in limited cases and special indications.
Aims: Mechanical bowel obstruction is a frequent surgical emergency and a frequently confronted burden in abdominal operation. This study aimed to find out the model of mechanical bowel obstruction in the Iranian population. Methods and materials: In this study, all patients with clinical and radiological evidence of mechanical bowel obstruction that admitted to the Department of Surgery of Baqiyatallah Hospital with a diagnosis of mechanical bowel obstruction from January 2012 to December 2015 were included. The age, gender, symptoms operative details, postoperative complications, outcome, and mortality, were recorded. Results: 193 patients with mechanical bowel obstruction were admitted in our study. Regarding the clinical presentation of the patients, the absence of passage of flatus and/or feces with abdominal pain (65.8%) were the most common presenting symptoms. Adhesions, colonic volvulus, hernias, different types of colorectal cancer were the most frequent causes of obstruction (54.9%, 15.54%, 7.2%, and 9.8%, respectively). Twenty-one patients died, resulting in a mortality rate of 10.9%. In the 19 patients with colorectal cancer, 7 (31.6%) patients have died and cause of death in all them related to cancer disease. Conclusion: The results showed that the most common mechanisms of intestinal obstruction were adhesions, volvulus, cancers, and hernias, respectively, and the most common risk factors were appendectomy history, herniation surgery history, and cholecystectomy history, respectively. About 21 patients (10.8%) underwent obstruction surgery with a diagnosis of malignancy, which was confirmed in 19 cases of tumor pathology, of which about one third had recurrence within 3 years.
