Computed Tomography Evaluation of Blunt Abdominal Injury

Sholy K Vareed Sholy K Vareed,Justine Antony Justine Antony,Don Paul Mathew Don Paul Mathew

doi:10.47009/ajmrr.2020.8.2.9

Sholy K Vareed Sholy K Vareed, Justine Antony Justine Antony + Show 1 more

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https://doi.org/10.47009/ajmrr.2020.8.2.9

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Abstract

Background: Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, particularly in patients with a decreased level of consciousness.Plain abdominal radiography has limited role in the assessment of blunt abdominal trauma, although some authorities continue to advocate its use. CT scan’s main advantage is the ability to detect arterial contrast extravasation, uncontained or as a pseudoaneurysm, which predicts the need for surgery or angioembolisation. The aim is to study computed tomography evaluation of blunt abdominal injury. Subjects and Methods: The present study was conducted in the Department of Radiology of the medical institution. For the study, we used abdomen CT scan reports of 100 patients with BAT, who were stable enough to undergo radiological investigation. The patients included 66 males and 34 females. All CT scans were obtained with a 16 slice MDCT Scanner (Siemens). All patients received intravenous bolus of iodinated contrast agents. Individual organ injuries were graded according to the American Association for the Surgery of Trauma (AAST - OIS) injury scoring scale. The overall imaging findings were analysed for their role in guiding the therapeutic options, whether conservative or surgical. Results: Total number of patients included in the study was 100. The mean age of patients was 41.97 years. Number of male patients was 66 and number of female patients was 34. For the mode of injury, other miscellaneous causes were most common in out study group followed by road traffic accidents. It was observed that OIS grade II patients were 19, OIS grade III patients were 29, OIS grade IV patients were 12 and OIS grade V patients were 10. The highest proportion of conservatively managed patients were seen in OIS grade II patients. Conclusion: Within the limitations of the present study, it can be concluded that CT scan for blunt abdominal injury is a reliable and accurate method for diagnosis. It has all the qualities to make it a gold standard for initial investigation of choice for blunt abdominal injury patients.

Highlights

Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, in patients with a decreased level of consciousness. [1,2] Confirmation of the presence or absence of injury relies largely on the use of diagnostic adjuncts
A large prospective observational study of patients with blunt polytrauma but no clinical signs of injury—which found radiological evidence of abdominal injury in almost 10% of patients—and a recent consensus guideline suggest that the threshold for investigation of blunt abdominal trauma should be low. [3,4] Plain abdominal radiography has limited role in the assessment of blunt abdominal trauma, some authorities continue to advocate its use
[5] computed tomography (CT) scan’s main advantage is the ability to detect arterial contrast extravasation, uncontained or as a pseudoaneurysm, which predicts the need for surgery or angioembolisation

Summary

Introduction

Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, in patients with a decreased level of consciousness. [1,2] Confirmation of the presence or absence of injury relies largely on the use of diagnostic adjuncts. Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, in patients with a decreased level of consciousness. A large prospective observational study of patients with blunt polytrauma but no clinical signs of injury—which found radiological evidence of abdominal injury in almost 10% of patients—and a recent consensus guideline suggest that the threshold for investigation of blunt abdominal trauma should be low. [3,4] Plain abdominal radiography has limited role in the assessment of blunt abdominal trauma, some authorities continue to advocate its use. Plain abdominal radiography does not visualise abdominal viscera or detect free fluid, so it cannot provide direct evidence of organ injury or indirect evidence of haemorrhage. [6] the present study was conducted to study computed tomography evaluation of blunt abdominal injury. Asian Journal of Medical Radiological Research Volume 8 Issue 2 July-December 2020

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