Prospective evaluation of blunt abdominal trauma by computed tomography

Abstract

Objectives: To evaluate the usefulness of emergency computed tomography in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine the choice of management (operative versus non-operative), thereby reducing the non-therapeutic laparotomy rates. The emphasis was to detect both free fluid (haemoperitoneum) and visceral lesions as indicators of intraabdominal injury. Materials and methods: Two hundred and ten patients with blunt abdominal trauma were evaluated in a period of 20 months, of whom sixty-three patients were positive. The various organ injuries were graded, and scoring applied for haemoperitoneum. The management, therapeutic or otherwise was decided based on the CT findings. Results: Patients with severe grades of injury and with large haemoperitoneum required surgeries. The overall sensitivity, specificity and positive predictive value for trauma detection by CT was 93%, 100% and 100% respectively. Conclusion: CT quantification of haemoperitoneum and organ injury grading is helpful in guiding the surgeon towards patient management. CT is accurate, safe, and has all the attributes to make it an initial investigation of choice in haemodynamically stable patients of blunt abdominal trauma.

Keywords

• CT in Blunt Abdominal Trauma
• Haemoperitoneum