Abstract
Adequate radiographic study of the abdomen after blunt trauma requires a knowledge of: (a) how the injury was sustained, (b) the site of bruises or contusions, (c) the presence or absence of fractures of the ribs, spine or pelvis, (d) evidence of bleeding from any of the natural orifices. This information indicates the site of the impact and the areas to be studied. Four types of bleeding are recognizable radiologically. (a) Subcapsular hematoma is signified by enlargement of the normal outline of the viscus. (b) Localized hemorrhage is shown by loss of outline of the organ and displacement of adjacent structures. (c) Intraperitoneal blood accumulates in the flanks and pelvis and is seen between the colon and the properitoneal fat lines in the flank and in the peritoneal reflections of the pelvis. (d) Retroperitoneal hemorrhage causes loss of normal outlines of the kidneys and psoas muscles. Within the pelvis it results in displacement of the rectum and bladder. Delayed rupture and bleeding is encountered in injury to all of the abdominal viscera, and a change in clinical status is an indication for a repeat radiographic examination.
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