Abstract
Background, The contextA prospective study was conducted involving 81 patients (mean age, 20.79 years) with abdominal trauma who underwent ultrasonography and post-contrast CT on MDCT scanner. The total DLP for each patient was reviewed, and the effective dose was calculated. Purpose of the study to: explore the role of MDCT in assessing traumatic abdominal lesions, demonstrate radiation dose delivered by MDCT, and describe specific CT technical features to minimize radiation.ResultsThe spleen was the most commonly injured organ (49.4%) followed by liver (39.5%) and kidney (24.7%). Pancreatic injury occurred in seven patients, whereas only two patients had intestinal injuries. One patient had adrenal injury. Minimal, mild and moderate free intra-peritoneal fluid collection was detected in 21 (25.9%), 47 (58%) and 10 (12.3%) patients, respectively. Only three (3.7%) patients had no collection. One patient had active uncontrolled bleeding and died. Radiation dose was below the detrimental level (calculated effective dose), with optimal image quality.ConclusionsMDCT is sensitive to all types of traumatic abdominal lesions. Not only in determining the injury, but also in its grading. MDCT has affected the treatment directions, spotting a focus on conservative treatment by raising the diagnostic confidence. FAST cannot be the sole imaging modality. The individual radiation risk is small but real. Advancements in medical imaging reduce radiation risk.
Highlights
Trauma is a major cause of death in developing countries where abdominal trauma accounts for approximately 10% of all deaths and 45% of morbidity [1]
Motor vehicle accidents accounted for 58% of all cases, followed by falling from height, accounting for 32.1% of all cases (Table 3)
We explored the role of Multi-detector computed tomography (MDCT) in diagnosing different traumatic abdominal injuries to assess its validity comparing to clinical follow-up, serial imaging and surgical findings as reference standards
Summary
Trauma is a major cause of death in developing countries where abdominal trauma accounts for approximately 10% of all deaths and 45% of morbidity [1]. Abdominal trauma can present with various organ injuries, depending on pattern of trauma (i.e., blunt or penetrating). Rapid and accurate investigations are essential for definitive management [2,3,4,5,6]. The abdomen is a diagnostic black box. Radiological assessment is required as clinical examination is. Multi-detector computed tomography (MDCT) provides supreme anatomical and physiological information that can differentiate trivial injuries from those requiring intervention. MDCT with multiplanar capability and three-dimensional (3D) reformatted images
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