CT For Abdominal Trauma Research Articles

Pattern of injuries in blunt trauma abdomen: A retrospective evaluation of imaging findings at a high-volume tertiary care trauma centre

Objective: Contrast-enhanced computed tomography (CECT) is the investigation of choice in trauma patients. The purpose of this study was to retrospectively evaluate the pattern, severity and association of abdominal injuries based on imaging at a high-volume tertiary trauma care centre. Methods: Retrospective evaluation of the CT records of patients over a period of 5 years was done at our institute. A total of 1519 patients who had undergone contrast-enhanced abdominal CT at a 64-slice Multidetector CT for abdominal trauma were included in this study. Inclusion criteria were: 1) History of blunt abdominal trauma, 2) Patients who had undergone a biphasic CECT abdomen scan. Exclusion criteria were: 1) Patients with penetrating injury, 2) Patients with incomplete data set/records. Results: Liver was the most common injured organ in both adult (38.8%) and paediatric population (40.9%). Significant higher incidence of mesenteric injury, bladder injury, spinal and rib fractures were seen in adult patients. Significant association of anorectal injuries (P=0.003) and bladder/urethral injuries with pelvic fractures was also seen (P<0.001). Conclusion: Our study provided important insights about the pattern, severity and association between the various abdominal injuries based on imaging findings in a large patient population. Larger studies with incorporation of clinical outcome in such patients can help in formulating appropriate management strategies.

Diagnostic Imaging for Blunt Abdominal Trauma

Background: Blunt abdominal trauma is a common cause of morbidity and mortality among patients encountering traumatic injuries, especially motor vehicle accidents, which are the leading cause of injury worldwide. Focused abdominal sonogram for trauma, computed tomography with or without contrast, and laparotomy are the most common ways of diagnosis and treatment. With advancement of diagnostic medicine, the physicians are making use of non-operative methods to achieve quick results quicker and with fewer complications. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: blunt abdominal injury, FAST scan, US in abdominal trauma, CT for abdominal trauma, trauma management Aim: In this review, we aimed at evaluating the various methods of diagnosis using imaging for blunt abdominal trauma. Conclusion: The growing tendency of non-operative management necessitates early identification of the injury sites, which is aided by the increasing sophistication of the CT techniques. Additionally, CT also provides a very significant method for following up the patients and for detecting complications which were not diagnosed initially.

Oral Contrast Agents for CT of Abdominal Trauma in Pediatric Patients: A Comparison of Dilute Hypaque and Water

Dilute Hypaque Sodium is generally well accepted as an oral contrast agent for CT of pediatric patients who have experienced recent blunt abdominal trauma. However, Hypaque can cause complications. Using water as a substitute contrast agent eliminates these potential complications. The purpose of our study was to compare the performance of water with that of dilute Hypaque as an oral contrast agent. Our hypothesis was that we would find no significant difference in performance between the two agents in defining anatomic details of the hollow gastrointestinal tract. We performed a retrospective review of 74 CT scans obtained in infants and children who had received blunt abdominal trauma, scoring the quality of visualization of bowel structures, the presence of non-bowel-related findings, and the confidence level in making each assessment. The date range of the scans reviewed overlapped with the period in which the oral contrast material used for scanning such patients was switched from dilute Hypaque to water. Of the 74 CT scans that we reviewed, 53 were obtained with dilute Hypaque and 21 were obtained with water. The sex distribution between the two groups was compared using a chi-square test, whereas the mean age was compared using a two-sample two-sided Student's t test. A two-sample one-sided Student's t test of equivalence was used to analyze the data. Sex distribution for the two groups of patients was not significantly different (69.81% of the group who received dilute Hypaque were boys; 68.18% of the group who received water were boys). Furthermore, the difference in the mean age for the two groups was not statistically significantly (dilute Hypaque group, 8.86 years; water group, 10.18 years). No statistically significant difference in performance of the contrast agents was found with respect to the detection of intraabdominal abnormality. As an oral contrast material, water performed as well as dilute Hypaque in facilitating visualization of all intraabdominal anatomic structures. In defining anatomic details of the hollow gastrointestinal tract, water is as effective as dilute Hypaque as an oral contrast agent for CT in the setting of acute blunt abdominal trauma in pediatric patients.

Can chest and abdominal trauma CT eliminate the need for plain films of the spine? – Experience with 329 multiple trauma patients

Purpose: To compare the accuracy of spine plain films with chest and abdominal trauma CT in detection of spine fractures. Methods: The study prospectively enrolled 329 multiple trauma patients. Of these, 38 patients had both chest CT for trauma and thoracic spine plain films, and 87 patients had both abdominal CT for trauma and lumbar spine plain films. Results: Of the fractures visible at either chest trauma CT or thoracic spine plain film examination, all were diagnosed on CT and 62 % on plain films. Of fractures visible at either abdominal trauma CT or lumbar spine plain films, 94 % were diagnosed on CT and 67 % on plain films. The one false negative CT involved an articular process fracture, which was visible but not mentioned, in a patient with a sacral fracture. Conclusion: Evaluation of the digital scout images and bone windows when a patient has chest and abdominal trauma CT appears to be as accurate as thoracic and lumbar spine plain films in the evaluation of spinal trauma.

CT of Abdominal Trauma

Dr. setiawan is Associate Professor of Radiology and Diector, division of Abdominal Imaging, Department of radiology, Univerisyt of Texas-Southwestern, Dallas, TX 75235

Imaging techniques in the diagnosis of gastrointestinal and hepatic disease.

Abdominal imaging continues to grow in importance for diagnosis, anatomic staging, and functional analysis of gastrointestinal ailments. In this review, we attempt to delineate those publications, both original investigations and summary articles, that have advanced our understanding of abdominal imaging in infants and children. Special attention is given to the newer modalities that provide previously unavailable methods to analyze abnormalities. These include Doppler ultrasonography and magnetic resonance imaging as well as CT for abdominal trauma. Interventional radiology techniques useful for treatment of gastrointestinal diseases are also discussed.

Use of oral contrast material in abdominal trauma ct scans: is it dangerous?

Use of oral contrast material in abdominal trauma ct scans: is it dangerous?

Use of oral contrast material in abdominal trauma CT scans: Is it dangerous? : Federle MP, Peitzman A, Krugh J. J Trauma: Injury, Infection and Critical Care. 1995;38(1):51-3

Use of oral contrast material in abdominal trauma CT scans: Is it dangerous? : Federle MP, Peitzman A, Krugh J. J Trauma: Injury, Infection and Critical Care. 1995;38(1):51-3

The Diagnostic Role of Enhanced CT for Abdominal Trauma

The Diagnostic Role of Enhanced CT for Abdominal Trauma

Safety-belt injuries in children with lap-belt ecchymosis: CT findings in 61 patients.

We have noted a complex of common injuries in children wearing lap-styled safety belts during vehicular accidents. Sixty-one children who were restrained passengers in motor vehicle crashes had linear ecchymosis across the abdomen and had CT for abdominal trauma. Thirteen children (21%) had a lumbar spine injury, and 14 children (23%) injured a hollow viscus (bowel, 12; bladder, two); five children (8%) had both spine and hollow viscus injuries. Abnormal findings on abdominal CT were recognized retrospectively in three of 13 children with lumbar spinal injury. Lateral radiographs of the spine showed lumbar spinal injury in all cases. Free intraperitoneal air was noted in on three (25%) of 12 children with bowel injury. In eight of those children, CT showed large, unexplained collections of peritoneal fluid. The presence of lap-belt ecchymosis should prompt a careful search for spine, bowel, and bladder injury. Recognition of the limitations of CT diagnosis of these injuries is important to reduce errors in interpretation.

In Reply: Is Hypaque Dangerous?

Drs Schlechter and Besserman have raised an interesting point concerning the use of diatrizoate sodium in abdominal trauma CT scans. We believe strongly that it is important to obtain excellent bowel opacification in order that injuries to the bowel can be delineated. Without bowel opacification, CT has little possibility of actually being able to discern mesenteric injuries, bowel hematomas, and areas of bowel laceration. Diatrizoate sodium is an ideal medium in this need because it provides excellent bowel opacification even in the setting of slowed bowel motility achieving a rapid transit time.

The frequency and significance of thoracic injuries detected on abdominal CT scans of multiple trauma patients.

Of 174 multiple trauma patients undergoing abdominal CT examination for suspected abdominal trauma, 65 patients had 109 chest injuries detected by abdominal CT, chest film, or both examinations. Forty-one patients had 55 chest injuries at the base of the thorax which were not detected on the initial chest film. The most frequent chest injuries detected only by CT were pneumothroax, fracture (rib, thoracic spine, and sternum), lung contusion, aspiration pneumonia, hemothorax, and post-traumatic atelectasis. Seven patients whose chest injury initially was seen only at abdominal CT required treatment of the injury, suggesting that a variety of chest injuries which may vitally affect patients can be detected early in multiple trauma patients by abdominal CT, and that all abdominal trauma CT scans should be scrutinized for signs of a chest injury.