Blunt thoracoabdominal trauma diagnosis using point of care ultrasound in the emergency room: A systematic review

Background: Blunt thoracoabdominal trauma is a common emergency condition which require rapid identification of internal injuries. Point-of-care ultrasound (POCUS), including Focused Assessment with Sonography for Trauma (FAST), extended FAST (eFAST), and contrast-enhanced ultrasound (CEUS), are used for bedside evaluation in trauma settings. We aimed to evaluate the diagnostic accuracy of POCUS modalities (FAST, eFAST, and CEUS) in identifying intra-abdominal and thoracic injuries in patients with blunt thoracoabdominal trauma.

Methods: A systematic search was conducted in PubMed, Embase, and Scopus for studies published between 2008 and 2025. Original studies in English assessing POCUS in blunt trauma were included. Data on study design, patient characteristics, ultrasound modality, and diagnostic performance were extracted. 

Results: Ten original studies with a total of 10,965 patients were included. Most studies evaluated FAST, some investigated eFAST or CEUS. FAST sensitivity differs in settings, ranging from 28% to 95%, and specificity was high. In pediatric cases, CEUS show better performance compared to standard ultrasound, with sensitivity and specificity up to 100%. Thoracic POCUS showed strong accuracy to detect pneumothorax. Operator experience and patient condition influenced diagnostic outcomes.

Conclusion: POCUS modalities are good methods in the early assessment of blunt thoracoabdominal trauma. CEUS give additional benefit in pediatric patients.