title: Imaging of abdominal and pelvic injuries from the Boston Marathon bombing.
abstract: The aim of this study is to describe the imaging findings of abdominal and pelvic injuries in victims of the Boston Marathon bombing. A retrospective review of 87 patients following the Boston Marathon bombing was performed to evaluate for abdominal and pelvic injuries on plain radiography or CT scans of the abdomen and pelvis. Imaging exams were evaluated for shrapnel, soft tissue injury, visceral damage, vascular disruption, and fractures. The injuries were classified as primary, secondary, tertiary, and quaternary blast injuries. Eleven of the 87 patients had positive findings in the abdomen or pelvis (M:F = 7:4, average age 34.6 years). There were 22 ball bearings, two nails, one screw, and two irregular metal fragments in the 11 patients with secondary blast (shrapnel) injuries. There was no peritoneal penetration or visceral injury seen in any of the patients. One patient had multiple transverse process fractures, representing tertiary blast injury. All but one patient had superficial penetrating abdominal or pelvic injuries secondary to shrapnel. There were no cases of bowel or solid visceral organ injuries due to the lack of peritoneal violation from the relatively low-powered explosions. Absence of peritoneal penetration by shrapnel indicates no need for laparotomy following low-powered explosions.
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital, Fruit street, Boston, MA, 02114, USA. mghpartners@yahoo.com.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Singh
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Brigham and Woman's Hospital, Boston, MA, 02115, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Sodickson
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital, Fruit street, Boston, MA, 02114, USA.
authors.forename: Hani
authors.initials: H
authors.lastname: Abujudeh
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000328:Adult; D001753:Blast Injuries / Q000000981:diagnostic imaging*; D054042:Bombs; D001900:Boston; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D054527:Mass Casualty Incidents; D009104:Multiple Trauma; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000293:injuries*; D012189:Retrospective Studies; D023481:Terrorism; D014057:Tomography, X-Ray Computed
keywords: Blast; Explosion; Shrapnel; Trauma