MDCT in blunt abdominal trauma, a good predictor for surgical management.

ABSTRACT

Aim: The aim of our study was to analyze the role of Multidetector computed Tomography (MDCT) in the classification and management of high energy blunt abdominal trauma. Material And Method: A Prospective study of 140 patients of all age groups was conducted from October 2010 to October 2012. Rectal and IV contrast were used. Angiography was performed in cases of suspected vascular trauma. Three dimensional reconstructions were done. CT findings were correlated and confirmed by either operative findings or follow-up CT. Result: 140 cases of blunt abdominal trauma were included in this study. Abdominal USG (Ultrasound) and MDCT were performed. Abdominal injuries were more common in males seen in 119 cases (89%). Spleen was the most common organ to be injured, affected in 40 patients (23%). Liver injury was seen in 36 cases, renal involvement in 30 cases, bowel in 20 cases, urinary bladder in 7 cases, a pancreatic injury in 3 cases and retro peritoneum involvement in 2 cases. Out of 140 patients 135 had free intraperitoneal fluid. USG findings and MDCT findings were compared with per operative findings. Patients managed conservatively were compared with repeat follow up CT findings. USG showed a sensitivity of 55 % and specificity of 75 % in solid organs injury and sensitivity of 95 % and specificity of 99 % in free fluid detection. MDCT showed a sensitivity of 97 % and specificity of 98 % in solid organs injury and 100%in hemoperitoneum. Conclusion: MDCT is the modality of choice to evaluate abdominal injury when there is doubt in clinical and USG findings, and to offer patient conservative management.