Delayed manifestations of abdominal trauma: follow-up abdominopelvic CT in posttraumatic patients

Elbanna, Khaled Y.; Mohammed, Mohammed F.; Huang, Shih-Chieh; Mak, David; Dawe, J. Philip; Joos, Émilie; Wong, Heather; Khosa, Faisal; Nicolaou, Savvas

doi:10.1007/s00261-017-1364-4

Cited by 12 publications

(10 citation statements)

References 40 publications

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“…In pancreatic trauma, contrast-enhanced CT-scan has high specificity (90–95%) but low sensitivity (52–54%) for ductal involvement. Up to 40% of PI can be missed or misdiagnosed on abdominal CT-scan obtained within 12 h of injury [96, 97]. PI becomes more evident 12–24 h after trauma [41, 67, 98].…”

Section: Methodsmentioning

confidence: 99%

“…CT-scan is usually the first-line imaging tool in the assessment of late complications of pancreatic trauma and very useful in driving management [39, 61, 71, 72, 76, 96, 135, 145, 233, 247, 248]. MRI is a reliable alternative to CT-scan in children and pregnant women [40, 45, 52, 97, 249, 250].…”

Section: Methodsmentioning

confidence: 99%

“…Pseudocyst is the most frequent complication following NOM [15, 52, 53, 64, 68, 69, 72, 154, 257, 258]. CT-scan is useful in evaluating pseudocysts and peripancreatic fluid collections following PI [96, 247, 259, 260] and in guiding percutaneous drainage [40]. US and endoscopic US (EUS) can also be used for follow-up and to guide percutaneous treatment of pseudocyst and abscess avoiding radiation exposure [45, 63, 70, 158, 247, 253].…”

Section: Methodsmentioning

confidence: 99%

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Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

et al. 2019

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Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

et al. 2019

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“…Investigating the frequency, cause, and type of delayed abdominal injuries helps raise the awareness of radiologists and emergency physicians to traumatic injuries that may indicate delayed presentation. [19] Several publications showed the mortality rates after pelvic fracture and associated injuries, and the mortality rates ranged from 7.6% to 19%. [20,21] In our study, the mortality rate was 6.6%.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Pelvic Fractures and Associated Injuries: The Statistical Analysis of 471 Pelvic Trauma Patients

Saydam

Şahin

Yılmaz

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:In most respects, the vast majority of pelvic injuries is not of a life-threatening status, but co-presence of other injuries needs to be diagnosed. This study aims to evaluate associated pelvic and extra-pelvic visceral organ injuries of the patients with closed pelvic fractures. METHODS:This retrospective study was conducted with 471 adult patients who had been admitted to our Emergency Service with the diagnosis of pelvic fractures. Type of fractures, accompanying visceral organ injuries, the demographic data, type of operation, mortality rates were recorded and analysed statistically. RESULTS:The rate of operations carried out by the general surgery clinic or other surgical clinics in each type of fracture according to AO classification did not differ (p=0.118). In patients with A2, A3 and B1 types of fractures, the operation rate of general surgery clinic did not show a significant difference. However, most of the patients who had extrapelvic surgery were in the mild severity pelvic trauma, such as AO A2 and A3. A total of 31 patients were ex-patients, 17 of whom had AO-A2 type of fractures. The findings showed that there was a significant difference between abdominal ultrasonography outcome that was normal and non-orthopedic surgery types (p<0.001). There was no significant difference between the types of surgery performed and Abdominal CT outcome, which was normal (p=0.215). CONCLUSION:In the management of patients with pelvic fractures irrespective of its type or grade, the findings suggests that greater attention should be paid to not to overlook the associated injuries. Early blood and imaging tests are encouraged after the patient's hemodynamic status is stabilized.

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“…A delay in abdominal closure can result in wound infection, wound dehiscence, and abscesses (12,15,39). Delayed manifestations of traumatic injuries have been reported in up to 20% of patients at CT follow-up within 30 days after initial polytrauma CT, including evolving or newly apparent solid organ injuries, evolving subcapsular hematomas, and fluid collections (68).…”

Section: Complications Of Injuries and Treatmentmentioning

confidence: 99%

Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries

et al. 2019

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After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient's condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24-48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.

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Delayed manifestations of abdominal trauma: follow-up abdominopelvic CT in posttraumatic patients

Abstract: A small percentage of traumatic injuries may be unidentified or fail to manifest on the initial CT, resulting in delayed manifestations of abdominopelvic trauma, which may lead to subsequent readmission, delayed management, and more severe medical complications.

Cited by 12 publications

References 40 publications

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Correlation of Pelvic Fractures and Associated Injuries: The Statistical Analysis of 471 Pelvic Trauma Patients

Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries

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