BLUNT ABDOMINAL-TRAUMA IN ADULTS - ROLE OF CT IN THE DIAGNOSIS AND MANAGEMENT OF VISCERAL INJURIES - PART-2 - GASTROINTESTINAL-TRACT AND RETROPERITONEAL ORGANS

Computed tomography plays an important role in the detection and manag ement of blunt visceral injuries in adults. Current standard examinati on techniques enable detection of the majority of perforating or devas cularizing bowel injuries, although diagnostic findings an often subtl e and meticulous inspection is required. Computed tomography may demon strate pancreatic contusions and lacerations and help in distinguishin g minor traumatic lesions without involvement of the pancreatic duct ( organ injury scale, grades I and II) from deep lacerations with ductal involvement (grades III and V). Computed tomography enables distingui shing renal contusions and minor cortical lacerations that can usually be managed conservatively (injuries of grades I-III) from corticomedu llary lacerations and injuries of the major renal vessels (grades IV a nd V) that have a less favorable prognosis and more commonly require s urgical repair. In addition, CT is well suited for the detection of ac tive renal hemorrhage and guidance of transcatheter embolization treat ment and delineation of preexisting benign or malignant pathologies th at may predispose to posttraumatic hemorrhage. The radiologist's aware ness of the diagnostic CT findings of abdominal visceral injuries as w ell as their clinical and surgical implications are important prerequi sites for optimal patient management.