Gastric traumatic injuries: CT findings

Lassandro, Francesco; Romano, Stefania; Rossi, Giovanni; Muto, R.; Cappabianca, Salvatore; Grassi, Roberto

doi:10.1016/j.ejrad.2006.04.028

Cited by 15 publications

(16 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These data were confirmed by an experimental model of rats that also demonstrated a higher frequency and grade of injury of other parenchymal organs in rats with full stomachs[15]. Moreover, a full thickness rupture is more frequently observed at the level of the fundus[11,16]. The mechanisms responsible for gastric injuries in blunt trauma include tangential tearing along fixed points, increased intraluminal pressure, and crushing against vertebral bodies[17].…”

Section: Discussionmentioning

confidence: 88%

“…Specific CT findings for gastric rupture include luminal content extravasation and discontinuity of the gastric wall, while CT findings suggestive of injury consisted of free peritoneal fluid, extraluminal air, pneumatosis, and thickening and hematoma of gastric wall[11]. …”

Section: Methodsmentioning

confidence: 99%

“…Although a wide spectrum of computed tomography (CT) findings has been described for gastric blunt traumas, no systematic instrumental approach exists in this setting[11]. For this reason, we sought to produce a radiological grading of gastric traumatic injuries in our study that might play a role in both the diagnostic phase of the emergency setting and prognostic stratification of these patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gastric blunt traumatic injuries: A computed tomography grading classification

Solazzo

Lassandro

2017

WJR

Self Cite

View full text Add to dashboard Cite

AIMTo produce a radiological grading of gastric traumatic injuries.METHODSIn our study, we retrospectively analyzed 32 cases of blunt gastric traumatic injuries and compared computed tomography (CT) data with patients’ surgical or medical development. In all cases, a basal phase was acquired, and an intravenous contrast material was administered via an antecubital venous catheter with acquisition in the venous phase (70-90 s). In addition, a further set of delayed scans was performed 4-5 min after the first scanning session, without supplementary intravenous contrast material, to identify or better define areas of active bleeding. All CT examinations were retrospectively reviewed by two radiologists, with more than 5 years of experience in emergency radiology, to detect signs of gastric injuries and/or associated abdominal lesions according to literature data. Specific CT findings for gastric rupture include luminal content extravasation and discontinuity of the gastric wall, while CT findings suggestive of injury consisted of free peritoneal fluid, extraluminal air, pneumatosis, and thickening and hematoma of gastric wall.RESULTSWe found 32 gastric traumatic injuries. In 22 patients (68.8%), the diagnosis was based on the surgical findings; in the other 10 patients (31.2%), the diagnosis was based on the clinical and CT radiological data. We observed discontinuity of the gastric wall and luminal content extravasation in 1 patient (3.1%); in 10 patients (31.2%), there was extra-luminal air in the peritoneum. In 28 patients (87.5%), there was peritoneal fluid, which was blood in 14 patients (hematoma in 11 patients and contrast material extravasation from active bleeding in 3 patients). In 15 patients (46.9%), there was gastric wall thickening. In 3 patients, it was possible to identify a prevalent involvement of the external layer of the gastric wall, whereas, in 2 patients, the inner side of the gastric wall presented with major involvement. In 3 patients (9.4%), pneumatosis of the gastric wall was detected. In 19 (59.4%) patients, the stomach was full. The fundus was the most frequently damaged part of the stomach because it was involved in 17 patients (53.1%). Based on the observed data, we identified four grades of gastric lesions.CONCLUSIONA radiologic score is helpful for guiding the diagnosis and management (surgical or conservative) of gastric blunt traumatic injuries and stratify patients according to short-term outcomes.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gastric blunt traumatic injuries: A computed tomography grading classification

Solazzo

Lassandro

2017

WJR

Self Cite

View full text Add to dashboard Cite

show abstract

“…In recent times, however, several papers have reported these signs in many clinical conditions other than intestinal ischaemia [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Most of these papers were case reports so that the unusual findings were magnified compared to the more common conditions.…”

Section: Clinical Significancementioning

confidence: 96%

“…In adults, IP and PMP have been usually considered indicative of advanced intestinal infarction [3][4][5]. Nevertheless, these findings have been reported in a wide range of pathological conditions including intra-abdominal abscess, diverticular disease, pylephlebitis, inflammatory bowel disease, acute gastric or intestinal dilatation, hepatic transplant, barium enema, umbilical catheterisation, chronic pulmonary disease, corticosteroid therapy, gastric volvulus, intestinal hernias, ingestion of corrosives, carcinoma of the colon, colonoscopy either optical or virtual, drugs, ulcerative disease, and trauma [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] (Table 1). Recently, IP and PMP have been described in patients treated with molecular targeted therapy, probably as a result of intestinal toxicity; all patients recovered spontaneously after discontinuation of therapy [26].…”

Section: Introductionmentioning

confidence: 99%

Imaging assessment and clinical significance of pneumatosis in adult patients

et al. 2014

Self Cite

View full text Add to dashboard Cite

Gas detection in the bowel wall and in portomesenteric venous vessels in adults has long been related to intestinal infarction and poor outcome; many case reports have shown that pneumatosis may be associated with a large variety of pathological situations, ranging from absolutely benign and asymptomatic forms to abdominal catastrophes. Several studies have been conducted on this topic with different conclusions, probably due to differences in population so that the clinical value of these signs is still questioned. Intestinal pneumatosis, especially if presenting with a band-like pattern and if associated with portomesenteric vein gas, when observed in an acute abdominal setting should raise the suspicion of mesenteric infarct and prompt a careful search for other signs of intestinal involvement, so as not to miss cases of life-threatening intestinal infarct or allow them to further evolve into extensive necrosis with worse prognosis. In this review we illustrate the most relevant aspects of these debated but significant radiological signs.

show abstract