ABSTRACT
Background: HELLP syndrome is life threatening condition. Diagnosis of HELLP syndrome plays an important role in assessment of complication. It can be done by USG and CT scan. Objectives: The aim of this study was to define role of CT scan in assessment of HELLP syndrome. Materials and methods: A case report aimed at evaluation of patient who came with sign and symptoms of HELLP syndrome to Radiology Department of Dhiraj Hospital by using CT scan. Results: A 30 year old patient presented in post-partum state with fever, rigor, nausea and tenderness in the right hypochondrium. Case history showed patient had suffered from pre-eclampsia during childbirth. The Patient had undergone ultrasonography which gave a diagnosis of hepatomegaly with liver abscess. Her Blood investigation showed total count of 22700 with predominant polymorph of 70%, Hb- 4.7 gm, SGPT was 234, Patient has thrombocytopenia with platelet of 1.5 lac. She was subjected to pre and post contrast CT scan in Dhiraj general hospital which showed hepatosplenomegaly, multiple ill-defined hypodense lesions in both lobes of liver (HU value = 52-70) with perilesional oedema, suggestive of multiple liver hematomas with rupture of hematoma into the peritoneal space. Conclusion: CT scan plays the key-role in assessment of complications in pre-eclamptic postnatal patient with HELLP syndrome which may be missed by USG. There by helping in patient management and prognosis.
ABSTRACT
Background: Diagnosis of abdominal trauma is a real. Diagnostic tools that help the treating doctor in optimum management of abdominal trauma include; Focused Assessment with Sonography for Trauma (FAST), Diagnostic peritoneal lavage (DPL) and CT Scan. Objectives: The aim of this communication was to define the recent role of FAST and CT scan of the abdomen in the diagnosis of abdominal trauma. Material and methods: This study aimed at evaluating patients who came to the Radiology Department of Dhiraj General Hospital, by using USG and CT scan. This study comprised of 50 patients. Results: Out of 50 patients of abdominal trauma, 12 patients (24%) were in age group 21-30 years with male to female ratio of approximately 5.2: 1. The commonest mode of trauma was road trafic accident according for 54% of total cases. Spleen and liver were the most common organs injured, followed by kidney. USG showed overall sensitivity 57.48%, specificity 97.77%, positive predictive value 88.9125, negative predictive value 97.185 and accuracy of 90.75%. CT scan showed highest sensitivity of 95.35%, specificity of 100%, positive predictive value of 100%, negative predictive value 77.78% and accuracy 96%. Conclusion: FAST is useful as the initial diagnostic tool for abdominal trauma to detect intra abdominal fluid. With proper training and understanding the limitations of ultrasound, the results of FAST can be optimized. DPL is indicated to diagnose suspected internal abdominal injury when ultrasound machine is not available, there is no trained person to perform FAST, or the results of FAST are equivocal or difficult to interpret in a hemodynamically unstable patient. In contrast, in hemodynamically stable patients the diagnostic modality of choice is CT with intravenous contrast. It is useful to detect free air and intra peritoneal fluid, delineate the extent of solid organ injury, detect retroperitoneal injuries, and help in the decision for conservative treatment. Helical CT is done rapidly which reduces the time the patient stays in the CT scan room. Furthermore, this improves sagittal and coronal reconstruction images which are useful for detecting ruptured diaphragm.