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Usefulness of Multidetector Computed Tomography for the Initial Assessment of Blunt Abdominal Trauma Patients

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Abstract

Background

The prompt detection and accurate localization of abdominal injuries are difficult. Some diagnostic modalities, including laboratory tests, ultrasound, and diagnostic peritoneal lavage (DPL) were used to evaluate patients with blunt abdominal trauma, with various advantages and pitfalls. We aimed to evaluate the risk and benefit of using multidetector computed tomography (MDCT) as an initial assessment tool for proper diagnosis and treatment planning of patients with blunt abdominal trauma.

Methods

Two hundred fifty-two patients with blunt abdominal trauma were prospectively enrolled. Multidetector computed tomography was performed during resuscitation. The risk and benefit of using MDCT in the diagnosis and planning of treatment were analyzed.

Results

The time required for a MDCT examination averaged 10.2 minutes. Of the studies done, 224 revealed abdominal injuries. Of those, 34 were performed in patients with unstable hemodynamic status without adverse effect. Prompt diagnosis and proper treatment were given according to the MDCT findings. A total of 43 (17.1%) MDCTs showed contrast extravasation. Active bleeding was confirmed in all and treated with transarterial embolization (30) or surgery (13). Another 58 patients sustained bowel, mesenteric, or pancreatic injuries (BMPI) necessitating laparotomy. The sensitivity, specificity, and accuracy of MDCT in identifying patients with active bleeding or BMPI were all 100%.

Conclusions

Multidetector computed tomography was useful as a second line initial assessment tool to identify injuries and determine treatment planning in blunt abdominal trauma patients. No increased risk was found if the facility is readily available, the protocol is well designed, and the patient is well prepared.

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Authors and Affiliations

  1. Trauma and Critical Care Center, Department of Surgery, Chang-Gung Memorial Hospital, 5, Fu-Hsing Street, Kweishan, Taoyuan, 333, Taiwan

    Jen-Feng Fang MD, Being-Chuan Lin MD & Yu-Pao Hsu MD

  2. Department of Radiology, Chang-Gung Memorial Hospital, 5, Fu-Hsing Street, Kweishan, Taoyuan, 333, Taiwan

    Yon-Cheong Wong MD

  3. Division of General Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, 5, Fu-Hsing Street, Kweishan, Taoyuan, 333, Taiwan

    Miin-Fu Chen MD

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  1. Jen-Feng Fang MD
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  2. Yon-Cheong Wong MD
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  3. Being-Chuan Lin MD
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  5. Miin-Fu Chen MD
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Correspondence to Jen-Feng Fang MD.

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Fang, JF., Wong, YC., Lin, BC. et al. Usefulness of Multidetector Computed Tomography for the Initial Assessment of Blunt Abdominal Trauma Patients. World J. Surg. 30, 176–182 (2006). https://doi.org/10.1007/s00268-005-0194-7

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  • DOI: https://doi.org/10.1007/s00268-005-0194-7

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