Remember the 3 "F" that are the most sensitive for acute pathologies

• • Fat stranding, free fluid, free air

Make the peritoneum a specific part of your search pattern!

• • Train your eyes to look between bowel loops

  • Use lung windows to assess for subtle free air/pneumoperitoneum

For trauma, be extra sensitive for another "F": fractures

Coronal view good for:

• • Transverse process fractures

  • Tracing sacrum and pubic rami

  • Correlation for possible spinal fractures

Look for fat stranding, edema, hematoma to increase sensitivity for acute fractures

Make the vessels a specific part of your search pattern!

Arterial

• • Trace the aorta and branch vessels, assessing for wall thickening, surrounding fat stranding, or acute aortic syndrome

Venous

• Trace the deep veins, assessing for DVT

Look within the plane of trauma, both penetrating and blunt

• Know the history/mechanism of trauma

• Soft tissue contusions can highlight the points of impact

• Assess underlying structures for injury (bowel/mesenteric contusion, vascular injury, etc.)

Assess the bowel and mesentery on coronal view

• Zoomed out, bigger picture view will increase sensitivity

• Compare bowel loops to assess for enhancement, thickening, dilatation

• More mesenteric fat to compare for fat stranding

Things to report for bowel obstruction

• Simple versus closed loop physiology (look for multiple transition points!)

• Complete/high grade vs incomplete/low grade (ability of material to pass)

• Transition point (can hedge if there is a suspected transition point)

• Signs of ischemia (e.g. thickening, fluid, pneumatosis)