Prospective evaluation of blunt abdominal trauma by computed tomography

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.

The Role of Computed Tomography in Blunt Abdominal Trauma

“…Road traffic accident is the commonest mode of injury in blunt injury abdomen. This is consistent with the studies of Kumar et al, 1 Radwan et al, 4 and Mohapatra et al 8 Other causes are fall injuries, physical assult. We also had some cases of blunt injury abdomen due to earthquake related injuries as Nepal suffered from 7.8 magnitute earthquake in the month of April, 2015.…”

“…Trauma is the leading cause of death in persons under 45 years of age, with 10% of these fatalities attributable to abdominal injuries. 1 Missed intra-abdominal injuries continue to cause preventable deaths. 2 Blunt Abdominal Trauma usually results following road traffic accidents, assaults, recreational accidents, or falls.…”

The range of abdominal surgical emergencies in children older than 1 year at the komfo anokye teaching hospital, Kumasi, Ghana

“…Since 2003, we have reviewed our stand on exploratory laparotomies for all cases of hemoperitoneum involving the spleen, taking into consideration the immunologic role of the spleen and the improvement of the diagnostic tools for blunt abdominal trauma in our hospital, and have evolved nonoperative methods of management of most splenic injuries, as accepted in many centers worldwide. [19,20] The penetrating abdominal injuries mainly involved accidental gunshot wounds, falls from heights [ Figure 2] and road traffic injuries.…”

Diagnostic accuracy of Multidetector Computed Tomography in Evaluation of Blunt Abdominal Injury

“…Also, liver and spleen are close to the lower ribs, so any fracture of the ribs can injure them. In Thimothy VO etal study [12] , Kumar MM et al study [13] and Podeanu M et al study [14] , spleen was the commonly injured organ followed by liver. In Redhu N etal study [15] of blunt injury in pediatric population also, spleen was most commonly involved in 37.5% cases followed by liver in 22.5%.…”