Diagnostic Limits, Blind Spots, and Pitfalls in CT Imaging of Blunt Abdominal Trauma

Abstract

Trauma is the leading cause of death for patients older than 45 years with abdominal injuries from blunt force trauma, contributing to a significant portion of these deaths.1 Most blunt abdominal injuries are due to motor vehicle collisions, falls from height, assaults, or sports. The most commonly injured abdominal organ from blunt trauma is the spleen, followed by the liver, kidneys, small bowel, urinary bladder, colon, diaphragm, and pancreas. The majority of these injuries can be treated successfully when identified early and managed appropriately. Multidetector CT (MDCT) provides unparalleled rapid detection and accurate characterization of intra-abdominal injuries and is the gold standard imaging examination in the triage of blunt abdominal injury. However, despite its undisputed superior examination performance, MDCT has known diagnostic limitations. An understanding of the diagnostic limitations of MDCT in the evaluation for blunt abdominal trauma, and an awareness of potential imaging pitfalls and blind spots, are imperative for radiologists to avoid false-positive and false-negative interpretations that may result in increased morbidity and potentially devastating patient outcomes.