Investigation of choice in an unstable patient with suspected intraabdominal injury’ is –
**Core Concept**
In unstable patients with suspected intraabdominal injury, the primary concern is to quickly and accurately diagnose the extent of internal bleeding or organ damage. This requires a rapid and non-invasive assessment tool that can guide further management.
**Why the Correct Answer is Right**
The investigation of choice in this scenario is **Focused Assessment with Sonography for Trauma (FAST)**. FAST is a bedside ultrasound examination that evaluates for free fluid in the abdominal cavity, which is indicative of internal bleeding or organ damage. It is quick, non-invasive, and can be performed simultaneously with other emergency procedures. The sonographic evaluation of the Morrison's pouch, hepatorenal recess, and splenorenal recess helps in detecting free fluid in the abdominal cavity.
**Why Each Wrong Option is Incorrect**
**Option A:** **CT Scan**. While CT scans are highly sensitive and specific for diagnosing intraabdominal injuries, they are not suitable for unstable patients due to the need for transportation to the radiology department and exposure to radiation.
**Option B:** **Laparotomy**. Diagnostic laparoscopy is not the initial investigation of choice in unstable patients, as it is an invasive procedure that may delay definitive management.
**Option C:** **Diagnostic Peritoneal Lavage (DPL)**. Although DPL can detect free fluid in the abdominal cavity, it is an invasive procedure that carries a risk of complications, making it less suitable for unstable patients.
**Clinical Pearl / High-Yield Fact**
In unstable patients with suspected intraabdominal injury, FAST is the preferred initial investigation due to its rapidity, non-invasiveness, and ability to guide further management.
**Correct Answer:** C.