Computed Tomography Evaluation of Blunt Abdominal Injury

Computed Tomography Evaluation of Blunt Abdominal Injury

  • Sholy K Vareed Associate Professor, Department of Radiodiagnosis, SNIMS, Chalakka, Ernakulam, India
  • Don Paul Mathew Assistant Professor, Department of Radiodiagnosis, SNIMS, Chalakka, Ernakulam, India
  • Justine Antony Senior Resident, Department of Radiodiagnosis, SNIMS, Chalakka, Ernakulam, India

Abstract

Background: Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, particularly in patients with a decreased level of consciousness.Plain abdominal radiography has limited role in the assessment of blunt abdominal trauma, although some authorities continue to advocate its use. CT scan’s main advantage is the ability to detect arterial contrast extravasation, uncontained or as a pseudoaneurysm, which predicts the need for surgery or angioembolisation. The aim is to study computed tomography evaluation of blunt abdominal injury. Subjects and Methods: The present study was conducted in the Department of Radiology of the medical institution. For the study, we used abdomen CT scan reports of 100 patients with BAT, who were stable enough to undergo radiological investigation. The patients included 66 males and 34 females. All CT scans were obtained with a 16 slice MDCT Scanner (Siemens). All patients received intravenous bolus of iodinated contrast agents. Individual organ injuries were graded according to the American Association for the Surgery of Trauma (AAST - OIS) injury scoring scale. The overall imaging findings were analysed for their role in guiding the therapeutic options, whether conservative or surgical. Results: Total number of patients included in the study was 100. The mean age of patients was 41.97 years. Number of male patients was 66 and number of female patients was 34. For the mode of injury, other miscellaneous causes were most common in out study group followed by road traffic accidents. It was observed that OIS grade II patients were 19, OIS grade III patients were 29, OIS grade IV patients were 12 and OIS grade V patients were 10. The highest proportion of conservatively managed patients were seen in OIS grade II patients. Conclusion: Within the limitations of the present study, it can be concluded that CT scan for blunt abdominal injury is a reliable and accurate method for diagnosis. It has all the qualities to make it a gold standard for initial investigation of choice for blunt abdominal injury patients.

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References

Weledji P. Perspectives on the Management of Abdominal Trauma. J Univer Surg. 2018;6(2):17.

Myers J. Focused assessment with sonography for trauma (FAST): the truth about ultrasound in blunt trauma. J Trauma. 2007;62:28. Available from: https://doi.org/10.1097/ta.0b013e3180654052.

Hoff WS, Holevar M, Nagy KK, Patterson L, Young JS, Arrillaga A, et al. Eastern Association for the Surgery of Trauma. Practice management guidelines for the evaluation of blunt abdominal trauma: the EAST practice management guidelines work group. J Trauma. 2002;53:602–617. Available from: https://doi.org/10.1097/00005373-200209000-00038.

Salim A, Sangthong B, Martin M, Brown C, Plurad D, Demetriades D. Whole body imaging in blunt multisystem trauma patients without obvious signs of injury. Arch Surg. 2006;141(5):468–475. Available from: https://doi.org/10.1001/archsurg.141.5.468.

Jansen JO, Yule SR, Loudon MA. Investigation of blunt abdominal trauma. BMJ. 2008;336(7650):938–942. Available from: https://dx.doi.org/10.1136/bmj.39534.686192.80.

Brody JM, Leighton DB, Murphy BL, Abbott GF, Vaccaro JP, Jagminas L, et al. CT of Blunt Trauma Bowel and Mesenteric Injury: Typical Findings and Pitfalls in Diagnosis. Radio Graphics. 2000;20(6):1525–1536. Available from: https://dx.doi.org/10.1148/radiographics.20.6.g00nv021525.

Bell C, Coleridge ST. A comparison of diagnostic peritoneal lavage and computed tomography (CT scan) in evaluation of the hemodynamically stable patient with blunt abdominal trauma. J Emerg Med. 1992;10(3):275–280. Available from: https://dx.doi.org/10.1016/0736-4679(92)90332-n.

Hamidi MI, Aldaoud KM, Qtaish I. The role of computed tomography in blunt abdominal trauma. Sultan Qaboos Univ Med J. 2007;7(1):41–46.

Becker CD, Spring P, Glättli A, Schweizer W. Blunt splenic trauma in adults: can CT findings be used to determine the need for surgery? Am J Roentgenol. 1994;162(2):343–347. Available from: https://dx.doi.org/10.2214/ajr.162.2.8310923.

Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Pract. 2014;4(2):599–599. Available from: https://dx.doi.org/10.4081/cp.2014.599.

Meyer DM, Thal ER, Coln D, Weigelt JA. Computed Tomog- raphy in the Evaluation of Children with Blunt Abdominal Trauma. Annals of Surg. 1993;217(3):272–276. Available from: https://dx.doi.org/10.1097/00000658-199303000-00009.

Published
2020-12-30
How to Cite
Sholy K Vareed, Don Paul Mathew, & Justine Antony. (2020). Computed Tomography Evaluation of Blunt Abdominal Injury. Asian Journal of Medical Radiological Research, 8(2), 57-60. https://doi.org/10.47009/ajmrr.2020.8.2.9
Section
Original Articles