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 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.

Is Hypaque Dangerous?

PEDIATRICS ◽  
1989 ◽  
Vol 83 (4) ◽  
pp. 650-650
Author(s):  
ROBERT SCHLECHTER ◽  
ABRAHAM BESSERMAN
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Ct Scanning ◽  
Ct Scans ◽  
Solid Organ ◽  
Abdominal Ct ◽  
Injured Child ◽  
Gastric Distention ◽  
Close Observation

Concerning the use of diatrizoate sodium (Hypaque) in abdominal CT scans described by Kane et al (Pediatrics 1988;82:11-15), we agree that there is certainly much to be gained from CT scanning in blunt abdominal trauma. We question the routine use of diatrizoate sodium in an injured child predisposed to gastric distention and vomiting. This is particularly dangerous when he or she is prone and restrained and close observation at the bedside is not possible. Solid organ injuries are well demonstrated without contrast, and injury to a viscus can be evaluated clinically and by routine roentgenographic procedures.

Computed tomography in the evaluation of blunt abdominal trauma

1989 ◽  
Vol 18 (4) ◽  
pp. 481
Author(s):  
WC Pevec ◽  
AB Peitzman ◽  
AO Udekwu ◽  
W Straub
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma

scholarly journals Evaluation and management of blunt injury abdomen based on focussed assessment with sonography in trauma

2020 ◽  
Vol 9 (1) ◽  
pp. 61
Author(s):  
Sameer Ahmed
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Blunt Injury ◽  
Predictive Values ◽  
Bedside Test ◽  
Intraabdominal Injuries ◽  
Low Sensitivity

Background: The initial evaluation of patient with multiple trauma is a challenging task. FAST (focussed assessment with sonography in trauma) provides a viable alternative to computed tomography in blunt abdominal trauma patient. The aim of this study was to find the accuracy and utility of FAST in clinical decision making, as well as limitations.Methods: A total of 100 patients with blunt abdominal trauma who underwent FAST examination were included. Positive scan was defined as the presence of free intraperitoneal fluid. The sonographic scoring for operating room triage in trauma (SSORTT Score) was calculated using cumulative sum of ultrasound score, systolic blood pressure, and pulse rate. FAST findings were compared with computed tomography findings and in operated cases compared with surgical findings & clinical outcome.Results: We determined SSORTT score in all 100 cases. In our study, the sensitivity, specificity, positive and negative predictive values for FAST in identifying intraabdominal injuries were 93.9%, 94.2%, 87.5%, and 97.2%. In our study we found out that patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy.Conclusions: In our study we found that FAST is a rapid, reproducible, portable and non-invasive bedside test, and can be performed at the same time as resuscitation. Ultrasound is limited mainly by its low sensitivity in directly demonstrating solid organs injuries.

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