EMERGENCY CT IN BLUNT ABDOMINAL-TRAUMA OF MULTIPLE INJURY PATIENTS

Multiple injury patients with blunt abdominal trauma (n=110) were exam ined by abdominal CT. An i.v., but not peroral, contrast medium was us ed, thereby eliminating the delay caused by administering peroral cont rast medium and any subsequent delay in making the diagnoses and begin ning operative treatment. Eighteen patients underwent emergency laparo tomy after the initial CT examination. The preoperative CT findings we re compared to the laparotomy findings. CT revealed all but one of the severe parenchymal organ lesions requiring surgery. The one liver lac eration that went undetected had caused hemoperitoneum, which was diag nosed by CT. The bowel and mesenteric lesions presented as intra-abdom inal blood, and the hemoperitoneum was discovered in every patient wit h these lesions. Fourteen patients also initially had positive abdomin al 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 makin g the essential diagnoses, but it did save time.