A prospective evaluation of computerized tomography scan findings in blunt abdominal trauma

Abstract

Background and objective: Evaluating patients with blunt abdominal trauma remains one of the most challenging aspects of acute trauma care. CT scan of abdomen remains the standard imaging modality for evaluation of abdominal trauma cases. The aim of this study is to evaluate CT scan findings in blunt abdominal trauma victims with respect to solid organ injuries, hollow viscus injuries, associated thoracic and abdominal wall injuries, associated hemoperitoneum, cause of injury and type of management. Methods: A cross-sectional study was conducted among 96 hemodynamically stable patients with history of blunt abdominal trauma who underwent CT scan examination in Rozh-halat Emergency Hospital from June 2021-January 2022; using a 64 multi-detector helical slice CT scanner. Data analysis were performed on patient’s demographics, mode and type of injury, CT scan findings and severity scorings, associated injuries and type of management. Results: The mean age of enrolled cases was 28.6 ± 18.6 ranged from 4-70 years. About two third (63.5%) were males and one third were females (36.5%). The most common cause of trauma was road traffic accident (64% of cases). Out of 96 trauma cases; 87.5% of patients had positive CT findings of which 50% had hemoperitoneum, 21.9% had pneumoperitoneum, 66.7% had no hallow viscous involvement, while 33.2% had hollow viscus involvement. One third of cases had associated abdominal wall injury. 56.4% of patients had multiple organ injury. Regarding solid organ injury; 66.7% of cases had spleen injury, (36.5%) had liver injury, Pancreas was involved in 12.5% of cases. RT& LT – kidneys showed grade 2 injury in (9.4%) & (6.3 %) respectively. Half of patients with positive CT scan findings had no lower chest injury findings. This study showed that 43.8% of cases were managed conservatively, 45.9% underwent laparotomy, the incidental finding of intra-operative hemoperitoneum which was negative in CT scan was only 1%. Conclusion: CT imaging is the diagnostic tool of choice for the evaluation of blunt abdominal trauma in haemo-dynamically stable patients as it can assist in detecting and evaluating other co-existing injuries such as lower thoracic, pelvic and spine injuries apart from its main role in accurate identification of intra -abdominal injuries and associated bleeding.