CT imaging in assessing the severity of retroperitoneal injuries in blunt abdominal trauma

Abstract

Background: Trauma is a leading cause of death in developing countries due to vehicular and railway accidents, of which abdominal trauma due to blunt injuries constitutes 13% mortality and 45% morbidity. The purpose of this study is to assess and diagnose the severity of those retroperitoneal injuries other than the common causes of abdominal trauma with multidetector computed tomography (MDCT) scanning with intravenous contrast being the gold standard diagnostic modality even in unstable patients.Methods: A total of 204 patients of these 147 patients were males (72%) and 57 were females (28%) were included of all age groups, who had sustained abdominal trauma due to vehicular, railways accidents and also due to trivial trauma and history of fall from heights.Results: Of the 204 patients included in our study, 110 patients (55%) had the maximum trauma affection to the kidneys, in which 48% constitutes grade I injury, which shows the high sensitivity of MDCT detecting early injuries. Nearly 12% patients had adrenal injuries, 24% had pancreatic injuries, although a small percentage also had delayed manifestation of pseudocyst formation in stable patients. Duodenal and colonic injuries constitute rest of 5% and 4% of the patients. All these patients had good correlation with the morphological MDCT grading of injuries and clinical correlation.Conclusions: MDCT is the imaging procedure of choice for early detection or ruling out the presence of retroperitoneal injuries in trauma patients, especially now with the newer faster MDCT, scanning can be performed more quickly, minimizing patient movement, respiratory motion and vascular pulsation.