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J Emerg Med. 2011 Feb;40(2):188-9. doi: 10.1016/j.jemermed.2009.07.029. Epub 2009 Oct 2.

The double-line sign: a false positive finding on the Focused Assessment with Sonography for Trauma (FAST) examination.

Author information

  • 1Section of Emergency Ultrasound, Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware, USA.

Abstract

BACKGROUND:

Emergency physicians commonly perform Focused Assessment with Sonography for Trauma (FAST) examinations to evaluate for free intraperitoneal fluid. Many ultrasound findings can be misinterpreted as free fluid, resulting in false-positive FAST examinations.

OBJECTIVES:

To describe a previously unreported ultrasound finding that can be misinterpreted as free intraperitoneal fluid.

CASE REPORT:

A 32-year-old man was stabbed in the left upper abdomen. A FAST examination was performed and a right perinephric fat pad was interpreted as showing free fluid in Morison's pouch. After transfer to a trauma center, a repeat FAST examination revealed no signs of intraperitoneal free fluid. Wound exploration showed no signs of penetration into the peritoneal cavity.

CONCLUSIONS:

When performing a FAST examination, a wedge-shaped hypoechoic area in Morison's pouch that is bounded on both sides by echogenic lines (the "FAST Double-Line Sign") is likely to represent perinephric fat and may result in a false-positive FAST examination.

Published by Elsevier Inc.

PMID:
19800756
[PubMed - indexed for MEDLINE]
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