CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2005; 15(02): 167-173
DOI: 10.4103/0971-3026.28794
Original Article

Prospective evaluation of blunt abdominal trauma by computed tomography

MM Kumar
Department of Radio diagnosis, Rangaraya Medical College & Govt. General Hospital, Kakinada- 533001, Andhra Pradesh, India
,
M Venkataramanappa
Department of Radio diagnosis, Rangaraya Medical College & Govt. General Hospital, Kakinada- 533001, Andhra Pradesh, India
,
I Venkataratnam
Department of Radio diagnosis, Rangaraya Medical College & Govt. General Hospital, Kakinada- 533001, Andhra Pradesh, India
,
N Kumar
Department of Radio diagnosis, Rangaraya Medical College & Govt. General Hospital, Kakinada- 533001, Andhra Pradesh, India
,
K Babji
Department of Radio diagnosis, Rangaraya Medical College & Govt. General Hospital, Kakinada- 533001, Andhra Pradesh, India
› Author Affiliations

Abstract

Objectives: To evaluate the usefulness of emergency computed tomography in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine the choice of management (operative versus non-operative), thereby reducing the non-therapeutic laparotomy rates. The emphasis was to detect both free fluid (haemoperitoneum) and visceral lesions as indicators of intraabdominal injury. Materials and methods: Two hundred and ten patients with blunt abdominal trauma were evaluated in a period of 20 months, of whom sixty-three patients were positive. The various organ injuries were graded, and scoring applied for haemoperitoneum. The management, therapeutic or otherwise was decided based on the CT findings. Results: Patients with severe grades of injury and with large haemoperitoneum required surgeries. The overall sensitivity, specificity and positive predictive value for trauma detection by CT was 93%, 100% and 100% respectively. Conclusion: CT quantification of haemoperitoneum and organ injury grading is helpful in guiding the surgeon towards patient management. CT is accurate, safe, and has all the attributes to make it an initial investigation of choice in haemodynamically stable patients of blunt abdominal trauma.



Publication History

Article published online:
31 July 2021

© 2005. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • BIBLIOGRAPHY

  • 1 K. Park. Textbook of Preventive and Social Medicine.17th Edition, 2002.
  • 2 Federle MP, Jeffrey RB Jr. Hemoperitoneum Studied by Computed Tomography. Radiology 1983; 148:187-192
  • 3 Mirvis SE, Whitley NO, Vainwright JR, Gens DR. Blunt hepatic trauma in adults: CT-based classification and correlation with prognosis and treatment. Radiology 1989; 171:27-32.
  • 4 Mirvis SE, Whitely NO, Gens DR. Blunt splenic trauma in adults: CT based classification and correlation with prognosis and treatment. Radiology 1989; 171: 33-39.
  • 5 Moore EE, et al (1990) Journal of Trauma-Injury Infection and Critical Care, 30, 1427-1429.
  • 6 Moore EE, et al (1989) Journal of Trauma-Injury Infection and Critical Care, 29, 1664-1666.
  • 7 Resciniti A, Fink MP, Raptopoulos V, Davidoff A, Silva WE. Nonoperative management of adult splenic trauma: development of a computed tomographic scoring system that detects appropriate candidates for expectant management. J Trauma 1988; 28:828-831.
  • 8 Lee F. Rogers. Radiology of skeletal trauma. 3rd edition. W.B.Saunders, 2002: 163-164.
  • 9 Udekwu PO, Gurkin B, Oller DW. The use of computed tomography in blunt abdominal injuries. Am Surg. 1996 Jan; 62(1):56-9.
  • 10 Brasel KJ, Olson CJ, Stafford RE, Johnson TJ. Incidence and significance of free fluid on abdominal computed tomographic scan in blunt trauma. J Trauma. 1998 May; 44(5): 889-92.
  • 11 Mallik Kshitish, Vashisht Sushma, Thakur Sanjay, Srivastava DN, Comparative Evaluation of Ultrasonography and CT in Patients with Abdominal Trauma: A Prospective Study Ind J Radiol Imag 2000; 10.
  • 12 Nolan BW, Gabram SG, Schwartz RJ, et al: Mesenteric injury from blunt abdominal trauma. Am Surg 61: 501-506, 1995.
  • 13 Umlas S-L, Cronan JJ. Splenic trauma: can CT grading systems enable prediction of successful nonsurgical treatment? Radiology, 1991;178: 481-487.
  • 14 Peitzman AB, Makaroun MS, Slasky BS, et al: Prospective study of computed tomography in initial management of blunt abdominal trauma. J Trauma 26: 585-592, 1986.
  • 15 Sriussadaporn S. CT scan in blunt abdominal trauma. Injury. 1993 Sep; 24(8): 541-4.