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Traumatic Injuries: Mechanisms of Lesions

  • Federica Romano
  • Francesca Iacobellis
  • Franco Guida
  • Ettore Laccetti
  • Antonia Sorbo
  • Roberto Grassi
  • Mariano Scaglione
Chapter

Abstract

The effects of each trauma are strongly related to the mechanisms of lesions. Forensic medicine distinguishes two main trauma categories: blunt and penetrating in nature.

Each mechanism recognizes different patterns of production, according to specific forces: direct impact, compression and acceleration/deceleration forces in blunt trauma and size of the implement, velocity and trajectory in penetrating trauma by stab or gunshot wounds.

Nowadays the use of improvised explosive devices as the ones encountered in terrorist attacks leads to a new particular pattern of lesions, known as blast injuries.

As victims of major trauma are often unconscious or may present multiple lesions, clinical evaluation is unreliable. MDCT has revolutionized the management of trauma victims in the past two decades. Modern CT scanners allow enhanced image resolution with a marked reduction of the time needed for scanning, thereby allowing examination of the whole body within a few minutes. As a member of the trauma team and responsible of the diagnostic process, radiologists play the major role of promptly recognizing lesions and detecting expected and unexpected injuries following each specific traumatic mechanism. Knowledge of the direction of forces, trajectory of wounds, predisposing factors (as the presence or absence of restraint devices in motor vehicle collisions), and position of the body at the impact, helps radiologists in depicting critical injuries before they become clinically evident, to address the most tailored and timely management.

Keywords

Mechanisms of lesions Penetrating trauma Blunt trauma Blast trauma MDCT trajectography 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Federica Romano
    • 1
  • Francesca Iacobellis
    • 1
    • 2
  • Franco Guida
    • 1
  • Ettore Laccetti
    • 1
  • Antonia Sorbo
    • 1
  • Roberto Grassi
    • 2
  • Mariano Scaglione
    • 1
    • 3
  1. 1.Department of Radiology“Pineta Grande” HospitalCastel Volturno (CE)Italy
  2. 2.Department of RadiologySecond University of NaplesNaplesItaly
  3. 3.Department of RadiologySunderland Royal Hospital, NHS TrustSunderlandUK

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