Title: Diagnostic accuracy of Multidetector Computed Tomography in Evaluation of Blunt Abdominal Injury
Authors: Pradeep T, Paul V Puthussery, Mohanan K, Brahmadathan MN, Abhilash Babu TG, Suny Thomas, Thahirabi KA
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.80
Abstract
Introduction: Rapid detection of life-threatening abdominal injuries and promptly initiating appropriate care reduces trauma related mortality and morbidity. Accurate clinical evaluation may be difficult in altered consciousness and in severe external injuries. Computed Tomography (CT) scans are very sensitive in identifying intra-abdominal injuries and helps to avoid unwanted exploratory laparotomy. In this study, we aim to assess the pattern of abdominal visceral organ injury identified during contrast enhanced multidetector CT scan in patients with blunt abdominal trauma and the accuracy of CT scan in detecting abdominal organ injury.
Materials and Methods: This was a prospective observational study conducted in the department of Radiodiagnosis, from January 2013 to June 2014. All hemodynamically stable patients referred from surgery department with history of blunt abdominal trauma for triphasic CT examination after a preliminary ultrasound showing fluid in the peritoneal cavity were included in the study. Injury to abdominal visceral organs and presence of free fluid in the peritoneal cavity were recorded. Injuries to liver, spleen and kidneys were graded. The data was managed with Microsoft Excel and the descriptive analysis of abdominal injuries were presented as percentages. The sensitivity, specificity, positive predictive value and negative predictive value of CT scan for detection of individual abdominal visceral organ injuries were also calculated based on findings seen during laparotomy in 32 patients.
Results and Conclusion: Among the 125 patients, most common were liver and spleen injuries (29.6% each, n=37) followed by renal injuries (19.2%, n = 24). When compared with the laparotomy findings CT scan was found to be very sensitive and specific in identifying injuries to liver, spleen, kidneys and urinary bladder; however it was less sensitive in identifying bowel and pancreatic injury and retroperitoneal hematoma.
Key words: Blunt injury, Abdomen, Computed tomography, Liver.
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