The role of computed tomography in blunt abdominal trauma as investigative tool conducted at tertiary level hospital, Vadodara.

Background: Evaluating patients who have sustained blunt abdominal trauma (BAT) remains one of the most challenging and resource-intensive aspects of acute trauma care. Missed intra-abdominal injuries continue to cause preventable deaths. Aims & Objective: To assess efficacy of CT scan (computed tomography) as accurate diagnostic tool for blunt abdominal trauma patients. Materials and Methods: 87 cases of blunt abdominal injury admitted in S.S.G hospital, Baroda during the period of August 2010 to November 2012 were included in the study after taking written informed consent. All these patients were thoroughly investigated. CT Scan was done for all hemodynamically stable patients. Recorded data included age, sex, type of injuries and scan results. Organ injuries were graded using the OIS (Organ Injury Scale) guidelines. Results: The study comprised of 87 patients having blunt abdominal injury. Majority of the patients were in the age group of 20-29 years. Most common organ injury were splenic (43%), liver (32%) and renal (11%). 95% (83 patients) were positive for abdominal injury and 5% (4 patients) were negative. The CT findings of hemoperitoneum and/or solid organ injury were confirmed in the 15 cases taken up for surgery. Conclusion: In this study CT scan was 100 % sensitive in diagnosis of blunt abdominal trauma. Negative CT scan discourage unnecessary urgent abdominal exploration.

Rasmussen’s encephalitis in an Indian child.

A 5 year old boy with history of recurrent seizures and progressive weakness in left upper & lower limb. On MRI scan atrophy of right cerebral hemisphere with prominent right sided sulci & sylvian fissure. Temporal horn of right lateral ventricle appears prominent. Body and genu of corpus callosum appears hypo plastic. Electroencephalography revealed moderate voltage record showing mixed activity comprising ill-defined 8-10 Hz alpha rhythm plus 4-7Hz waves and random background delta components at 3Hz frequency. A clinical diagnosis of focal tonic-clonic epilepsy was made secondary to Rasmussen’s encephalitis, based on the features MRI scan findings of the brain.

A Large Hepatoblastoma in an Infant.

A prematurely born, 11 month old male child presented with history of lump over right side of upper abdomen for four months. Hepatomegaly with palpable lump in right hypochondriac and epigastric region was noted. ALT, AST & alpha feto protein were elevated with anaemia. On ultrasonography, ill-defined hypo echoic densely calcified mass lesion with internal vascularity noted in right lobe of liver. CT abdomen shows enlarged liver with heterogeneously enhancing mass lesion with necrotic areas and dense calcifications. Histopathologically diagnosis of hepatoblastoma was confirmed.

Retroperitoneal fibrosis in young female.

A 26 years old female presented with dull aching flank pain with elevated ESR, C - reactive protein and positive anti-nuclear antibody (ANA). Hypo echoic thin strip was noted in bilateral perirenal region without hydronephrosis on ultrasonography. Delayed enhancing perirenal rim of hypo dense soft tissue in bilaterally perinephric space on CT abdomen. Histological diagnosis of retroperitoneal fibrosis was confirmed.