What type of scanning remains the most sensitive test for hollow viscus injury?

The most sensitive test for detecting hollow viscus injury is the Focused Assessment with Sonography for Trauma (FAST) exam. This ultrasound-based examination is particularly advantageous in trauma settings because it is rapid, non-invasive, and can be performed at the bedside. The FAST exam efficiently identifies free fluid in the abdominal cavity, which might suggest a perforation or laceration of hollow organs such as the intestines or bladder.

By detecting the presence of fluid, the FAST exam can prompt further diagnostic or therapeutic measures, which is critical in managing patients with suspected internal injuries. While other imaging modalities like Computed Tomography (CT) can provide more detailed images and are very effective in the evaluation of abdominal injuries, they are not as sensitive in the very acute setting of trauma due to the time taken to perform the scan and potential contrast use. Ultrasound can also miss certain types of injuries compared to the FAST exam specifically tailored for trauma assessment and fluid detection.

The cervical spine radiographic evaluation primarily focuses on spinal injuries and does not evaluate the abdominal cavity, making it irrelevant when discussing hollow viscus injury. This underscores the specialized role of the FAST exam in trauma assessments where immediate decision-making is crucial.