The Role of Repeat Computed Tomography Scan in the Evaluation of Blunt Bowel Injury

2012 ◽  
Vol 78 (9) ◽  
pp. 979-985 ◽  
Author(s):  
Mark L. Walker ◽  
Ignatius Akpele ◽  
Stanston D. Spence ◽  
Vernon Henderson
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Injury Severity ◽  
Bowel Perforation ◽  
Closed Head Injury ◽  
Bowel Injury ◽  
Abdominal Ct ◽  
Enhanced Sensitivity

The precise role of repeat abdominal computed tomography (CT) imaging in the diagnosis and management of bowel injury is unclear. We reviewed 540 patients with blunt abdominal trauma managed at a Level II trauma center over a 5-year period to better define the role of repeat imaging. One hundred patients had a repeat abdominal CT scan within 72 hours of admission. These patients were young with multisystem injuries (mean ± standard deviation age, 34 ± 15 years; Injury Severity Score, 21 ± 12; Glasgow Coma Score [GCS], 12 ± 5). There were 14 patients with bowel injuries. All bowel-injured patients survived without abdominal morbidity. Time to repeat CT was shortest in the bowel injured group (20 ± 10 hours). The repeat CT was most helpful in patients with significant closed head injury (mean GCS, 3 ± 1) and in those with occult bowel injury. The repeat scan resulted in a change in clinical management in 26 patients. Regarding the presence of bowel perforation, the follow-up scan enhanced sensitivity from 30 to 82 per cent. The repeat abdominal CT is best used selectively in patients with blunt abdominal trauma and can provide clinically useful information to exclude bowel injury.

scholarly journals Duodenal Perforation following Blunt Abdominal Trauma Presenting as Normal in Abdominal Computed Tomography

2014 ◽  
Vol 21 (6) ◽  
pp. 396-399 ◽  
Author(s):  
Pk Tsai ◽  
Yt Yeh ◽  
Cb Yeh
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Life Support ◽  
Optimal Time ◽  
Advanced Trauma Life Support ◽  
Duodenal Perforation ◽  
Abdominal Ct ◽  
Abdominal Computed Tomography ◽  
Repeat Examination

Most emergency department (ED) physicians implement the Advanced Trauma Life Support (ATLS) approach, including primary and secondary survey, for the assessment of blunt abdominal trauma (BAT) patients. This report emphasizes the need for repeat Focused Assessment with Sonography for Trauma (FAST) and abdominal computed tomography (CT) if a BAT patient's condition persists or worsens. After initial negative FAST and abdominal CT findings, it is recommended that BAT patients with suspected intraabdominal injury should receive repeat examination in an optimal time. We report a patient who sustained duodenal perforation following BAT diagnosed by repeat ultrasound examination and abdominal CT scan. (Hong Kong j.emerg.med. 2014;21:396-399)

The role of computed tomography in the evaluation of blunt abdominal trauma in children

1981 ◽  
Vol 16 (3) ◽  
pp. 316-323 ◽  
Author(s):  
Melvyn P. Karp ◽  
Donald R. Cooney ◽  
Paul E. Berger ◽  
Jerald P. Kuhn ◽  
Theodore C. Jewett
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma

scholarly journals No need for surgery? Patterns and outcomes of blunt abdominal trauma

2019 ◽  
Vol 4 (3) ◽  
pp. 100-107
Author(s):  
Maximilian Goedecke ◽  
Florian Kühn ◽  
Ioannis Stratos ◽  
Robin Vasan ◽  
Annette Pertschy ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Intestinal Perforation ◽  
Injury Severity ◽  
Organ Injury ◽  
Free Fluid ◽  
Trauma Patients ◽  
Severe Injuries ◽  
Severity Of Injury

AbstractIntroductionThe management of a patient suffering from blunt abdominal trauma (BAT) remains a challenge for the emergency physician. Within the last few years, the standard therapy for hemodynamically stable patients with BAT has transitioned to a non-operative approach. The purpose of this study is to evaluate the outcome of patients with BAT and to determine the reasons for failure of non-operative management (NOM).Materials and methodsAnalysis of 176 consecutive patients treated for BAT was conducted in a German level 1 trauma center from 2004 to 2011. Abdominal injuries were classified according to the American Association for the Surgery of Trauma (AAST). Patients included were demonstrated to have objective abdominal trauma with either free fluid on focused assessment with sonography for trauma (FAST) or computed tomography (CT), or proven organ injury.ResultsPatients, 142 of 176 (80.7%), with BAT were initially managed non-operatively, with a success rate of 90%. The rates of NOM success were higher among those with less severe injuries; 100% with Abbreviated Injury Scale (AIS) of 1. In total, 125 patients (71.0%) were managed non-operatively, and 51 (29.0%) required surgical intervention. NOM failure occurred in 9.2% of the patients, the most common reason being initially undiagnosed intestinal perforation (46.2%). Positive correlation was identified (r = 0.512; p < 0.001) between the ISS (injury severity score) and the NACA (National Advisory Committee of Aeronautics) score. The delay in operation in NOM failure was 6 h in patients with underlying hepatic or splenic rupture and 34 h with intestinal perforation. The overall mortality of 5.1% was attributed especially to old age (p = 0.016), high severity of injury (p < 0.001), and greater need for blood transfusion (p < 0.001).ConclusionNOM was successful for the vast majority of blunt abdominal trauma patients, especially those with less severe injuries. NOM failure and operative delay were most commonly due to occult hollow viscus injury (HVI), the detection of which was achieved by close clinical observation and abdominal ultrasound in conjunction with monitoring for rising markers of infection and by multidetector computed tomography (MDCT) if additionally indicated. Based on this concept, the delay in operation in patients with NOM failure was short. This study underscores the feasibility and benefit of NOM in BAT.

Pediatric blunt abdominal trauma: Role of computed tomography vascular blush

1997 ◽  
Vol 32 (8) ◽  
pp. 1196-1200 ◽  
Author(s):  
Charles S Cox ◽  
James D Geiger ◽  
Donald C Liu ◽  
Kim Garver
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma
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