Helical Ct of Abdominal Trauma

Novelline, Robert A.; Rhea, James T.; Bell, T V

doi:10.1016/s0033-8389(05)70113-5

Cited by 88 publications

(53 citation statements)

References 34 publications

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“…The kidney injury was treated conservatively with no TPND in 17 (55%) children who had an isolated renal injury; two required surgical intervention 3 months after the trauma because of secondary urinary obstruction. Catheter placement was satisfactory in all seven procedures; the mean (range) duration of drainage was 18 (16)(17)(18)(19)(20)(21)(22) days in patients with isolated renal trauma, but was 4 (3-6) months in patients with a PERL. Obstruction and extravasation were successfully relieved and urinomas resolved in all seven patients.…”

Section: Resultsmentioning

confidence: 90%

Blunt renal trauma in children with previously undiagnosed pre‐existing renal lesions and guidelines for effective initial management of kidney injury

Önen¹,

Kaya²,

Çığdem³

et al. 2002

BJU International

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Objectives To record pre-existing renal lesions (PERL) found incidentally during evaluation for blunt renal trauma in children, determine their importance, suggest guidelines for the effective initial management of children with significant renal trauma and to evaluate the role of temporary percutaneous nephrostomy tube drainage (TPND) in these patients. Patients and methods We reviewed 338 children who were hospitalized with blunt abdominal trauma between 1992 and 2000. Thirty-one patients had significant renal injury, 17 before 1997 (reviewed retrospectively) and the others reviewed and followed prospectively. Results Eleven of the 31 children had a PERL, which had been undiagnosed before the injury. The mean (range) follow-up was 52 (15-104) months. There were 22 boys and nine girls (mean age 9.1 years, range 2-13).The mean age was lower in patients with a PERL than in children with isolated renal injury. The most common cause of blunt renal injuries was a fall (45%) followed by motor vehicle accidents. Renal stones were present in five children, pelvi-ureteric junction obstruction in four, megaureter in one and a renal cyst in one. The mean injury severity scores were 12in the children with a PERL and 14 in patients without. TPND was used in seven (22%) children; four were associated with a PERL. The mean grade of injury score for the kidney was higher in patients with a PERL and in children who underwent TPND than in patients who previously had a normal kidney and in children who did not undergo TPND. Early surgical intervention was required in three children; all were associated with a PERL. Of the 13 children who underwent surgery 11 had previous disease. Conclusions The frequency of PERL is high (36%) in children with blunt renal trauma. PERL can predispose minor trauma to cause kidney injury even with no evidence of hydronephrosis. When a minor trauma results in renal injury, it is important to seek a PERL.In selected patients, TPND may decrease the length of hospital stay and improve the outcome of the injured kidney, thereby decreasing the need for further surgery in those with isolated renal injury; however, it appears not to decrease the need for later operations in children with a PERL.

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Section: Resultsmentioning

confidence: 90%

Blunt renal trauma in children with previously undiagnosed pre‐existing renal lesions and guidelines for effective initial management of kidney injury

Önen¹,

Kaya²,

Çığdem³

et al. 2002

BJU International

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“…İntravenöz kontrast madde (IVKM) infüzyonuna başladıktan 70-90 sn sonra gö-rüntüler elde edilmelidir. 1,8 Abdominal travmalara yönelik yapılan BT'de oral kontrast madde kullanılması tartışma-lıdır. Oral kontrast madde barsak ansları ve mezenteri görüntülemede, barsak anslarını hematom, hemoraji ve pankreas yaralanmasından ayırt etmeye yardımcı olur ancak verilen oral kontrast maddenin vücuda dağılması için gereken zaman, travmada tanı ve tedaviyi geciktirebilir.…”

Section: Introductionunclassified

Computed tomography findings of abdominal trauma

Önder¹,

Kuday²,

Gür³

et al. 2012

Sakarya Med J

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ÖzetKarın travmaları; baş, boyun ve toraks travmalarından sonra üçüncü en sık ölüm nedenidir. Travmalara bağlı ölümlerin yaklaşık % 10' u abdominal yaralanmalara bağlı gelişir. Künt solid organ yaralanmalarının nonoperatif tedavisinin önünü açan en büyük faktör Bilgisayarlı Tomografi(BT) olmuştur. BT, yaralanmaların anatomisini doğru bir şekilde ortaya koyar. İntraperito-neal sıvının miktarı, retroperitoneal yapılar ve gastrointestinal sistem hakkında çok önemli bil-giler verir. Günümüzde BT olmadan solid organ yaralanmalarının konservatif tedavisinin gerçekleştirilmesi çok güçtür. BT karaciğer, dalak, böbrek, pankreas ve sindirim borusunun trav-ma sonrası evrelemesi tedavi ve takibinde önemli katkılar sağlamaktadır. AbstractAbdominal trauma, the third most common cause of death after head, neck and chest in-juries. %10 of trauma related deaths develops due to abdominal injury. Computed Tomography (CT) has been paving the biggest factor in the way for nonoperative treatment of blunt solid organ injuries. CT exposes accurately to the anatomy of injuries. It is provide very important information about, the amount of intraperitoneal fluid, retroperitoneal structures, and the gastrointestinal system. Today, it is very difficult the realization of solid organ injury with conservative treatment without CT. CT provides a significant contribution staging of trauma liver, spleen, kidney, pancreas and digestive tract, treatment and follow-up. Keywords GirişKarın travmaları; baş, boyun ve toraks travmalarından sonra travmalara bağlı ölüm nedenleri içerisinde üçüncü sıklıktadır. Travmalara bağlı ölümlerin yaklaşık % 10' u abdominal yaralanmalara bağlı gelişir.1,2 Karın travmaları kafa ve göğüs travmalarından daha az ölümcül olmalarına rağmen, kendisine bağlı ölümlerin erken tanı ve tedavisi yapıldığında en yüksek oranda önlenebilir travma grubu olması nedeni ile önemini korumaktadır.3 Oluş mekanizması bakımından trafik kazaları, iş kazaları, yüksekten düşme ve darp gibi olaylar künt travma grubuna girerler. Künt solid organ yaralanmalarında, Avrupa ülkelerinde olduğu gibi, ülkemizde de trafik kazaları en ön sırayı almaktadır. 4Künt solid organ yaralanmalarının nonoperatif tedavisinin önünü açan en büyük faktör Bilgisayarlı Tomografi (BT) olmuştur. BT; yaralanmaların anatomisini doğru bir şekil-de ortaya koyar.

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“…Isolated acetabular fractures are not associated with increased risk of bladder perforation [31]. Extraperitoneal bladder rupture accounts for 80±90 % of pediatric cases and is almost invariably associated with pelvic fracture [32]. Intraperitoneal bladder rupture is usually associated with blunt force to a full bladder causing disruption at the dome [32].…”

Section: Bladder Perforationmentioning

confidence: 99%

“…Extraperitoneal bladder rupture accounts for 80±90 % of pediatric cases and is almost invariably associated with pelvic fracture [32]. Intraperitoneal bladder rupture is usually associated with blunt force to a full bladder causing disruption at the dome [32]. Although bladder wall hematoma/contusion and extraperitoneal bladder rupture are often managed nonoperatively, intraperitoneal bladder rupture requires surgical exploration [33].…”

Section: Bladder Perforationmentioning

confidence: 99%

CT evaluation of pediatric abdominal trauma: pitfalls and quandaries

Hollingsworth

Bisset

2001

Emergency Radiology

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CT of the pediatric abdomen after blunt trauma has become a widely accepted technique for evaluation of hepatic and splenic injury. However, detection of hollow viscus and pancreatic injury remains challenging and controversial. Detection of bowel rupture (extravasated oral contrast, bowel discontinuity), pancreatic injury (laceration, separation of fragments) and bladder rupture may be difficult, particularly with inadequate technique and lack of vigilance. This article reviews findings associated with several injuries which may present diagnostic pitfalls as well as technical factors relating to the administration of enteric contrast and CT cystography.

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Helical Ct of Abdominal Trauma

Cited by 88 publications

References 34 publications

Blunt renal trauma in children with previously undiagnosed pre‐existing renal lesions and guidelines for effective initial management of kidney injury

Blunt renal trauma in children with previously undiagnosed pre‐existing renal lesions and guidelines for effective initial management of kidney injury

Computed tomography findings of abdominal trauma

CT evaluation of pediatric abdominal trauma: pitfalls and quandaries

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