Emergency CT in blunt abdominal trauma of multiple injury patients.
Multiple injury patients with blunt abdominal trauma (n = 110) were examined by abdominal CT. An i.v., but not peroral, contrast medium was used, thereby eliminating the delay caused by administering peroral contrast medium and any subsequent delay in making the diagnoses and beginning operative treatment. Eighteen patients underwent emergency laparotomy after the initial CT examination. The preoperative CT findings were compared to the laparotomy findings. CT revealed all but one of the severe parenchymal organ lesions requiring surgery. The one liver laceration that went undetected had caused hemoperitoneum, which was diagnosed by CT. The bowel and mesenteric lesions presented as intra-abdominal blood, and the hemoperitoneum was discovered in every patient with these lesions. Fourteen patients also initially had positive abdominal CT findings; 10 of them underwent an additional abdominal CT within 3 days, but the repeat studies did not reveal any lesions in need of surgery. Omission of the oral contrast medium did not jeopardize making the essential diagnoses, but it did save time.
Department of Diagnostic Radiology, Töölö Hospital, Helsinki, Finland.
J
J
Kinnunen
A
A
Kivioja
K
K
Poussa
E M
EM
Laasonen
D000007:Abdominal Injuries / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage; D004630:Emergencies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006465:Hemoperitoneum / Q000000981:diagnostic imaging; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries; D007813:Laparotomy; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D013161:Splenic Rupture / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery
D003287:Contrast Media; D006454:Hemoglobins