[Evidence-based Diagnosis of Abdominal Trauma]

Overview

Journal Radiologe

Specialty Radiology

Date 2008 Apr 17

PMID 18414828

Citations 2

Authors

G Schueller

Affiliations

Soon will be listed here.

Abstract

Abdominal trauma is a common cause of death particularly in patients up to 40 years of age. In order to reduce mortality a rapid radiologic diagnosis is essential. At present, sonography plays a role only in the evaluation of minor trauma and as a "focused assessment with sonography for trauma" (FAST) to clarify free intraperitoneal fluid immediately on admittance in severely injured patients. However, computed tomography has proven to be a potent tool for the triage of patients with abdominal trauma, because, based on the results of the CT scan, patients can be referred for laparotomy or safely classified for "wait and see" treatment. Therapeutic decisions are largely based on injury severity scores and the radiologist must be familiar with them as well as with the associated therapeutic consequences.

Citing Articles

The key role of the radiologist in the management of polytrauma patients: indications for MDCT imaging in emergency radiology.

Schueller G, Scaglione M, Linsenmaier U, Schueller-Weidekamm C, Andreoli C, De Vargas Macciucca M Radiol Med. 2015; 120(7):641-54.

PMID: 25634793 DOI: 10.1007/s11547-015-0500-x.

[Mountain biking : Breezy ups and traumatic downs].

Schueller G Radiologe. 2010; 50(5):460-70.

PMID: 20361176 DOI: 10.1007/s00117-009-1940-x.

References

Poletti P, Kinkel K, Vermeulen B, Irmay F, Unger P, Terrier F . Blunt abdominal trauma: should US be used to detect both free fluid and organ injuries?. Radiology. 2003; 227(1):95-103. DOI: 10.1148/radiol.2271020139. View

Nast-Kolb D, Waydhas C, Kanz K, Schweiberer L . [An algorithm for management of shock in polytrauma]. Unfallchirurg. 1994; 97(6):292-302. View

Becker C, Mentha G, Terrier F . Blunt abdominal trauma in adults: role of CT in the diagnosis and management of visceral injuries. Part 1: liver and spleen. Eur Radiol. 1998; 8(4):553-62. DOI: 10.1007/s003300050433. View

Moore E, Cogbill T, Jurkovich G, Shackford S, Malangoni M, Champion H . Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995; 38(3):323-4. DOI: 10.1097/00005373-199503000-00001. View

Richards J, Knopf N, Wang L, McGahan J . Blunt abdominal trauma in children: evaluation with emergency US. Radiology. 2002; 222(3):749-54. DOI: 10.1148/radiol.2223010838. View

Acosta J, Rodriguez P . Morbidity associated with four-wheel all-terrain vehicles and comparison with that of motorcycles. J Trauma. 2003; 55(2):282-4. DOI: 10.1097/01.TA.0000080525.77566.ED. View

Deck A, Shaves S, Talner L, Porter J . Computerized tomography cystography for the diagnosis of traumatic bladder rupture. J Urol. 2000; 164(1):43-6. View

Abrams B, Sukumvanich P, Seibel R, Moscati R, Jehle D . Ultrasound for the detection of intraperitoneal fluid: the role of Trendelenburg positioning. Am J Emerg Med. 1999; 17(2):117-20. DOI: 10.1016/s0735-6757(99)90040-2. View

Leidner B, Adiels M, Aspelin P, Gullstrand P, Wallen S . Standardized CT examination of the multitraumatized patient. Eur Radiol. 1998; 8(9):1630-8. DOI: 10.1007/s003300050601. View

10.

Luks F, Lemire A, St-Vil D, Di Lorenzo M, Filiatrault D, Ouimet A . Blunt abdominal trauma in children: the practical value of ultrasonography. J Trauma. 1993; 34(5):607-10; discussion 610-1. DOI: 10.1097/00005373-199305000-00001. View

11.

Farahmand N, Sirlin C, Brown M, Shragg G, Fortlage D, Hoyt D . Hypotensive patients with blunt abdominal trauma: performance of screening US. Radiology. 2005; 235(2):436-43. DOI: 10.1148/radiol.2352040583. View

12.

Moore E, Shackford S, Pachter H, McAninch J, Browner B, Champion H . Organ injury scaling: spleen, liver, and kidney. J Trauma. 1989; 29(12):1664-6. View

13.

Nunes L, Simmons S, Hallowell M, Kinback R, Trooskin S, Kozar R . Diagnostic performance of trauma US in identifying abdominal or pelvic free fluid and serious abdominal or pelvic injury. Acad Radiol. 2001; 8(2):128-36. DOI: 10.1016/s1076-6332(01)90057-1. View

14.

Linsenmaier U, Krotz M, Hauser H, Rock C, Rieger J, Bohndorf K . Whole-body computed tomography in polytrauma: techniques and management. Eur Radiol. 2002; 12(7):1728-40. DOI: 10.1007/s00330-001-1225-x. View

15.

Cogbill T, Moore E, Jurkovich G, Morris J, Mucha Jr P, Shackford S . Nonoperative management of blunt splenic trauma: a multicenter experience. J Trauma. 1989; 29(10):1312-7. DOI: 10.1097/00005373-198910000-00002. View

16.

Becker C, Mentha G, Schmidlin F, Terrier F . Blunt abdominal trauma in adults: role of CT in the diagnosis and management of visceral injuries. Part 2: Gastrointestinal tract and retroperitoneal organs. Eur Radiol. 1998; 8(5):772-80. DOI: 10.1007/s003300050471. View

17.

Todd Miller M, Pasquale M, Bromberg W, Wasser T, Cox J . Not so FAST. J Trauma. 2003; 54(1):52-9; discussion 59-60. DOI: 10.1097/00005373-200301000-00007. View

18.

Emery K, McAneney C, Racadio J, Johnson N, Evora D, Garcia V . Absent peritoneal fluid on screening trauma ultrasonography in children: a prospective comparison with computed tomography. J Pediatr Surg. 2001; 36(4):565-9. DOI: 10.1053/jpsu.2001.22283. View

19.

Rieger M, Sparr H, Esterhammer R, Fink C, Bale R, Czermak B . [Modern CT diagnosis of acute thoracic and abdominal trauma]. Anaesthesist. 2002; 51(10):835-42. DOI: 10.1007/s00101-002-0369-7. View

20.

Pearl W, Todd K . Ultrasonography for the initial evaluation of blunt abdominal trauma: A review of prospective trials. Ann Emerg Med. 1996; 27(3):353-61. DOI: 10.1016/s0196-0644(96)70273-1. View