CT assessment of abdominal hemorrhage in coagulopathic patients: impact on clinical management.
BACKGROUND
To assess how computed tomography (CT) affected clinical management in coagulopathic patients with suspected spontaneous abdominal hemorrhage.


METHODS
Fifty-four patients with coagulopathy underwent CT for possible abdominal hemorrhage. Medical records were reviewed retrospectively for pre-CT management strategy, degree of clinical suspicion for abdominal hemorrhage, CT findings, and post-CT management strategy.


RESULTS
Abdominopelvic CT demonstrated hemorrhage in 31/54 (57%) of patients; 20/54 (37%) of patients had retroperitoneal hemorrhage, 2/54 (4%) had hemoperitoneum, and 9/54 (17%) had hemorrhage confined to the thigh, groin, and/or abdominal wall. CT directly affected clinical management in 28/54 (54%) cases; 17/31 (55%) CT scans that were positive for hemorrhage had a clinical impact versus 11/23 (48%) negative CT scans. This difference was not statistically significant (p = 0.61). CT scans with a higher pretest suspicion for abdominal hemorrhage were more likely to have hemorrhage detected (p = 0.0046) but not more likely to have a clinical impact (p = 0.73).


CONCLUSIONS
CT to assess for abdominal hemorrhage had a direct impact on clinical management in about one-half of coagulopathic patients. Positive and negative CT studies were equally likely to affect management.
Nazarian
L N
LN
Department of Radiology, 7th Floor, Main Building, Thomas Jefferson University Hospital, 132 South 10th Street, Philadelphia, PA 19107-5244, USA.
Lev-Toaff
A S
AS
Spettell
C M
CM
Wechsler
R J
RJ
D000005:Abdomen / Q000098:blood supply; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001778:Blood Coagulation Disorders; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000209:etiology; D006474:Hemorrhagic Disorders / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants