Role of Contrast Enhanced CT in Assessment of Blunt Abdominal Trauma in Comparison to Ultrasonography

Abstract

Background Clinical examination fails to accurately diagnose many intraabdominal injuries in blunt abdomen and hence there is a well need for a good imaging technique.US and CT satisfy this to a great extent. With minimum technical limitations and a short time for examination US and CT become extremely useful in guiding the trauma surgeon. CECT is a highly useful imaging modality for diagnosis of blunt abdominal trauma. However US can be used as a useful initial modality. US and CT grading were of not much impact in the management of liver trauma, however extremely useful in the decision making of renal trauma and to a lesser extent in splenic injuries. CT is excellent in picking up clinically unsuspected trauma especially involving liver, kidney and bowel. Aim of the Work The aim of this study is to define and compare the role of CE-MDCT and FAST in detection of intraabdominal organs’ injuries and hemoperitoneum. And to highlight the value added by CE- MDCT in hemodynamically stable patients providing an accurate and highly sensitive diagnostic method for blunt abdominal trauma. Patients and Methods A prospective study was done in radio diagnosis department in Al Sherouk Police hospitals, and Zagzaig university hospitals-radiology department – ultrasound and CT units. 12 months, from 1/11/2018 to 1/11/2019. Results In this study CT detected 18 cases of splenic trauma compared to US which detected only 10 cases. Of the 8 additional cases detected on CT two were of grade IV injury and required surgery. CE-MDCT detected100% of splenic injuries confirmed clinically/surgically thus has been the gold standard method of detecting splenic injuries. CT detected 41 cases of haemoperitoneum which is 91% among all the cases of blunt injury to the abdomen. Conclusion CT is a superior diagnositic modality in the diagnosis of abdominal trauma.