The FAST (Focused Assessment with Sonography in Trauma) examination evaluates four windows for free intraperitoneal fluid. Which window is NOT part of the standard FAST examination?

• A Perihepatic (hepatorenal recess / Morrison's pouch)
• B Subxiphoid (pericardial window)
• C Perisplenic (splenorenal recess)
• D Parasternal long-axis window for aortic valve pathology ✓

Explanation

The four standard FAST windows are: (1) subxiphoid/subcostal (pericardial), (2) right upper quadrant/perihepatic (Morrison's pouch — hepatorenal recess), (3) left upper quadrant/perisplenic (splenorenal/perisplenic recess), and (4) suprapubic/pelvic (pouch of Douglas or rectovesical pouch). The parasternal long-axis echocardiographic window is used in formal echocardiography but is not part of the standard FAST protocol. The extended FAST (eFAST) adds bilateral anterior thoracic windows to detect pneumothorax.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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