PERIPORTAL TRACKING IN PEDIATRIC BLUNT ABDOMINAL-TRAUMA - CORRELATIONWITH LIVER-ENZYMES AND LIVER-INJURY

This is a retrospective study of the computed tomography (CT) examinat ions and medical records of 243 consecutive pediatric patients sent fo r CT studies after blunt abdominal trauma. The purpose of the study wa s to determine the frequency and significance of periportal tracking i dentified by CT, and correlate this finding with liver enzyme levels a nd liver injury Periportal tracking (PPT) was divided into four grades (0-3) depending upon the distribution of decreased attenuation adjace nt to the portal vessels. Circumferential PPT extending to the periphe ry of the liver (grade 3) was found in 20/243 children. They had a hig her incidence of liver parenchymal injury seen on CT 20% versus 0.5% i n combined PPT grades 0-2. Sixteen children with grade 3 PPT and no li ver injury had significantly elevated liver enzymes as compared to chi ldren with combined 0-2 grade PPT. Eleven of the 20 children with grad e 3 PPT had no other CT evidence of intraabdominal injury and none of these patients developed intraabdominal hemorrhage. Thus, grade 3 peri portal tracking as an isolated abnormality did not indicate a clinical ly significant liver injury in any patient.