scholarly journals The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture

2012 ◽  
Vol 1 (1) ◽  
pp. 24-26
Author(s):  
Edward Passos ◽  
Bartolomeu Nascimento ◽  
Fernando Spencer Netto ◽  
Homer Tien
Keyword(s):  
Ct Scan ◽  
Blunt Trauma ◽  
New Technologies ◽  
Motor Vehicle ◽  
Diaphragmatic Rupture ◽  
High Morbidity ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Traumatic Diaphragmatic Rupture

ABSTRACT Background Blunt traumatic diaphragmatic rupture (BTDR) occurs when signicant deceleration mechanism and energy are applied to the torso, and it is associated with signicant injuries and high morbidity and mortality. Although it has limitations, CT scan is the diagnostic of choice for BTDR. This study is a retrospective analyse of our experience in diagnosing BTDR using the 64-slice CT scanner. Sensitivity and specicity of this exam were assessed. Methods We reviewed reports from 2006 to 2009 of all CT scans of the abdomen that were done in the rst 24 hours of hospitalization of blunt trauma patients. We compared CT ndings to surgery reports. Results Our cohort consisted of 2670 patients; 69% were male. We found 28 cases of BTDR, most of them on the patient s left side (54%). Eleven percent of cases were bilateral. BTDR was often caused by motor vehicle collisions. We found sensitivity of 86%, specicity of 99%. Conclusion CT scan is reliable tool in blunt trauma patients. As new technologies arise, its sensibility and specicity also increases. How to cite this article Passos E, Nascimento B, Netto FS, Tien H, Rizoli S. The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture. Panam J Trauma Critical Care Emerg Surg 2012;1(1):24-26.

Trauma in pregnancy: A review of the Pennsylvania Trauma Systems Foundation database

Trauma ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Meike Schuster ◽  
Natasha Becker ◽  
Amanda Young ◽  
Michael J Paglia ◽  
A Dhanya Mackeen
Keyword(s):  
Blunt Trauma ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Blunt Injury ◽  
Trauma Patients ◽  
Severely Injured ◽  
Trauma Systems ◽  
Severely Injured Patients ◽  
Vaginal Deliveries ◽  
Injured Patients

Objective The goal of this study is to determine if injury severity score (ISS) of ≥9 and systolic blood pressure (SBP) predict poor maternal/pregnancy outcomes in blunt and penetrating trauma, respectively. Methods The Pennsylvania Trauma Systems Foundation database was used to identify pregnant trauma patients. Blunt trauma patients were analyzed with regard to ISS, while penetrating trauma patients were analyzed to determine whether SBP < 90 mmHg was predictive of poor maternal outcome. Results Patients with severe blunt injury (ISS ≥ 9) due to motor vehicle accident were less likely to wear seatbelts (51% vs. 63%, p = 0.005), and delivery was required in 17% of these patients as compared to 6% of the less severely injured, and only 6% of those were vaginal deliveries. Severely injured patients were discharged home 68% of the time and 6% died compared to less severely injured patients of which 83% were discharged home and <1% died; all other patients required discharge to a rehabilitation facility. Patients with penetrating trauma and SBP < 90 mmHg on arrival were more likely to require delivery (35% vs. 5%, p < 0.001) and were 14 times more likely to die (58% vs. 4%, p < 0.001) when compared to the normotensive group. Conclusion ISS ≥ 9 and SBP < 90 mmHg are predictors for poor outcomes after trauma during pregnancy. Severely injured blunt trauma patients often require surgery and delivery. Patients who present with SBP < 90 after penetrating trauma are more likely to deliver and are 14 times more likely to die.

The role of associated injuries on outcome of blunt trauma patients sustaining pelvic fractures

Injury ◽  
2000 ◽  
Vol 31 (9) ◽  
pp. 677-682 ◽  
Author(s):  
Jose Gustavo Parreira ◽  
Raul Coimbra ◽  
Samir Rasslan ◽  
Andrea Oliveira ◽  
Marcelo Fregoneze ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Associated Injuries

scholarly journals Impact of MRI on changing management of the cervical spine in blunt trauma patients with a ‘negative’ CT scan

2016 ◽  
Vol 1 (1) ◽  
pp. e000016 ◽  
Author(s):  
Mohamed A Mohamed ◽  
Karl D Majeske ◽  
Gul Sachwani-Daswani ◽  
Daniel Coffey ◽  
Karim M Elghawy ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Blunt Trauma ◽  
Trauma Patients

Role of routine pelvic radiography in initial evaluation of stable, high-energy, blunt trauma patients

2012 ◽  
Vol 30 (9) ◽  
pp. 724-727 ◽  
Author(s):  
Shahram Paydar ◽  
Fariborz Ghaffarpasand ◽  
Mehdi Foroughi ◽  
Ali Saberi ◽  
Maryam Dehghankhalili ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
High Energy ◽  
Initial Evaluation ◽  
Trauma Patients ◽  
Pelvic Radiography

scholarly journals Evaluation of Chest CT Scan as a Screening and Diagnostic Tool in Trauma Patients with Coronavirus Disease 2019 (COVID-19): A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest Ct Scan

Background. The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT  scan as a screening measure of COVID-19 in trauma patients. Methods. This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT scans were evaluated in a blinded manner, and the main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two Radiological Society of North America (RSNA) categories with the highest probability of COVID-19 pneumonia (i.e., typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID-19 pneumonia into “negative CT scan group.” Results. Chest CT scan had a sensitivity of 68%, specificity of 56%, positive predictive value of 34.8%, negative predictive value of 83.7%, and accuracy of 59.3% in detecting COVID-19 among trauma patients. Moreover, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals, a sensitivity of 100%, specificity of 66.7%, and negative predictive value of 100% were obtained ( p value: 0.05). Conclusion. Findings of the study indicated that the CT scan’s sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 compared with nontraumatic people.

Utility of Plain Film Pelvic Radiographs in Blunt Trauma Patients in the Emergency Department

2006 ◽  
Vol 72 (10) ◽  
pp. 951-954 ◽  
Author(s):  
Amal Kamil Obaid ◽  
Andrew Barleben ◽  
Diana Porral ◽  
Stephanie Lush ◽  
Marianne Cinat
Keyword(s):  
Emergency Department ◽  
Ct Scan ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Plain Film ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Pelvic Radiographs ◽  
Highly Sensitive ◽  
Pelvic Embolization

The objective of this study was to evaluate the utility and sensitivity of routine pelvic radiographs (PXR) in the initial evaluation of blunt trauma patients. A retrospective review was performed. One hundred seventy-four patients with a pelvic fracture who had computed tomography (CT) and PXR were included (average age, 36.1; average Injury Severity Score, 16.3). Nine (5%) patients died. Five hundred twenty-one fractures were identified on CT. One hundred sixteen (22%) of these fractures were missed by PXR. Eighty-eight (51%) patients were underdiagnosed by PXR alone. The most common fractures missed by PXR were sacral and iliac fractures. Eight patients required angiograms, with four undergoing therapeutic pelvic embolization. Forty-seven (27%) patients were hypotensive or required a transfusion in the emergency department. These patients were more likely to require an angiogram (17% vs 0%, P < 0.0001) and were more likely to require embolization (9% vs 0%, P < 0.001). This study demonstrates that CT scan is highly sensitive in identifying and classifying pelvic fractures. PXR has a sensitivity of only 78 per cent for identification of pelvic fractures in the acute trauma patient. In hemodynamically stable patients who are going to undergo diagnostic CT scan, PXR is of little value. The greatest use of PXR may be as a screening tool in hemodynamically unstable patients and/or those that require transfusion to allow for early notification of the interventional radiology team.

scholarly journals Diagnosis of diaphragm injuries using modern 256-slice CT scanners: too early to abandon operative exploration

2018 ◽  
Vol 3 (1) ◽  
pp. e000251
Author(s):  
Rindi Uhlich ◽  
Jeffrey David Kerby ◽  
Patrick Bosarge ◽  
Parker Hu
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Multidetector Ct ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Level Of Evidence ◽  
Diaphragm Injury ◽  
Hernia Formation ◽  
Operative Exploration ◽  
Ct Scanners

BackgroundMissed injury of the diaphragm may result in hernia formation, enteric strangulation, and death. Compounding the problem, diaphragmatic injuries are rare and difficult to diagnose with standard imaging. As such, for patients with high suspicion of injury, operative exploration remains the gold standard for diagnosis. As no current data currently exist, we sought to perform a pragmatic evaluation of the diagnostic ability of 256-slice multidetector CT scanners for diagnosing diaphragmatic injuries after trauma.MethodsA retrospective review of trauma patients from 2011 to 2018 was performed at an American College of Surgeons-verified level 1 trauma center to identify the diagnostic accuracy of CT scan for acute diaphragm injury. All patients undergoing abdominal operation were eligible for inclusion. Two separate levels of CT scan technology, 64-slice and 256-slice, were used during this time period. The prospective imaging reports were reviewed for the diagnosis of diaphragm injury and the results confirmed with the operative record. Injuries were graded using operative description per the American Association for the Surgery of Trauma guidelines.ResultsOne thousand and sixty-eight patients underwent operation after preoperative CT scan. Acute diaphragm injury was identified intraoperatively in 14.7%. Most with diaphragmatic injury underwent 64-slice CT (134 of 157, 85.4%). Comparing patients receiving 64-slice or 256-slice CT scan, there was no difference in the side of injury (left side 57.5% vs. 69.6%, p=0.43) or median injury grade (3 (3, 3) vs. 3 (2, 3), p=0.65). Overall sensitivity, specificity, and diagnostic accuracy of the 256-slice CT were similar to the 64-slice CT (56.5% vs. 45.5%, 93.7% vs. 98.1%, and 89.0% vs. 90.2%).DiscussionThe new 256-slice multidetector CT scanner fails to sufficiently improve diagnostic accuracy over the previous technology. Patients with suspicion of diaphragm injury should undergo operative intervention.Level of evidenceI, diagnostic test or criteria.

Intracerebellar Hemorrhage in a Premature Newborn: Diagnosis by Real-Time Ultrasound and Correlation with Autopsy Findings

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 159-162 ◽  
Author(s):  
Jeffrey M. Perlman ◽  
James S. Nelson ◽  
William H. McAlister ◽  
Joseph J. Volpe
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Premature Infant ◽  
Brain Imaging ◽  
Real Time ◽  
Critically Ill ◽  
Ultrasound Scan ◽  
Ultrasound Scanning ◽  
Ct Scanner

The identification of intracerebellar hemorrhage in a living premature infant by real-time ultrasound scan and confirmation of the findings at autopsy are described. This represents the first demonstration of the value of this noninvasive, convenient, and safe means of brain imaging in diagnosis of this lesion. Previous studies have described the role of the computed tomography (CT) scan in identification of intracerebellar hemorrhage in the newborn. Because infants with intracerebellar hemorrhage are usually critically ill, a means of identification of the lesion that could be utilized at the bedside rather than an approach that requires transport to a CT scanner is needed. This study indicates that portable real-time ultrasound scanning can satisfy that need.

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