CT of hemodynamically unstable abdominal trauma |
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Authors: | A Petridis M Pilavaki E Vafiadis P Palladas S Finitsis A Drevelegas |
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Institution: | (1) Department of Radiology, General Hospital “G. Papanikolaou,” GR-570 10 Exohi-Thessaloniki, Greece, GR |
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Abstract: | This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41
patients with abdominal trauma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CT was also carried out.
On CT, 25 patients had hemoperitoneum. Thirteen patients had splenic, 12 hepatic, 6 pancreatic, 8 bowel and mesenteric, 12
renal and 2 vascular injuries. Seven patients had retroperitoneal and 2 patients adrenal hematomas. All but five lesions (three
renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h following the injury. Postcontrast
studies (n = 17), revealed 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on
noncontrast CT. Surgical confirmation (n = 21) was obtained in 81.81 % of splenic, 66.66 % of hepatic, 83.33 % of pancreatic, 100 % of renal, 100 % of retroperitoneal,
and 85.71 % of bowel and mesenteric injuries. The majority of false diagnoses was obtained with noncontrast studies. Computed
tomography is a remarkable method for evaluation and management of patients with hemodynamically unstable abdominal trauma,
but only if it is revealed in the emergency room. Contrast injection, when it could be done, revealed lesions that were not
suspected on initial plain scans.
Received: 13 March 1997; Revision received: 1 December 1997; Accepted: 6 May 1998 |
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Keywords: | : CT Abdominal trauma Unstable hemodynamic condition |
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