CT of hemodynamically unstable abdominal trauma

This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41 patients with abdominal tra uma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CIT was also carried out. On CT, 25 patients had hemoperitoneum. Thirteen pati ents had splenic, 12 hepatic. 6 pancreatic. 8 bowel and mesenteric, 12 rena l and 2 vascular injuries. Seven patients had retroperitoneal and 2 patient s adrenal hematomas. All but five lesions (three renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h followi ng the injury. Postcontrast studies (n = 17), reveled 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on noncontrast CT. Surgical confirmation (n = 21) was obtained in 81 .81% of splenic, 66.66% of hepatic, 83-33% of pancreatic, 100% of renal, 10 0% of retroperitoneal, and 85.71% of bowel and mesenteric injuries. The maj ority of false diagnoses was obtained with noncontrast studies. Computed to mography is a remarkable method for evaluation and management of patients w ith hemodynamically unstable abdominal trauma, but only if it is revealed i n the emergency room. Contrast injection, when it could be done, revealed l esions that were not suspected on initial plain scans.