Multidetector CT for Penetrating Torso Trauma: State of the Art

Abstract

The use of computed tomography (CT) for hemodynamically stable victims of penetrating torso trauma continues to increase but remains less singular to the work-up than in blunt trauma. Research in this area has focused on the incremental benefits of CT within the context of evolving diagnostic algorithms and in conjunction with techniques such as laparoscopy, endoscopy, and angiographic intervention. This review centers on the current state of multidetector CT as a triage tool for penetrating torso trauma and the primacy of trajectory evaluation in diagnosis, while emphasizing diagnostic challenges that have lingered despite tremendous technological advances since CT was first used in this setting 3 decades ago. As treatment strategies have also changed considerably over the years in parallel with advances in CT, current management implications of organ-specific injuries depicted at multidetector CT are also discussed.

The role of computerized tomography in penetrating abdominal trauma

“…(Table 4). found in this study, both in anterior abdomen trauma (PPV=100% and NPV=93.3%) and in the dorsum or TAT (PPV=100% and PPV=95.5%), are consistent with other works 13,17 and show that CT is reliable for the definition of therapeutic management.…”

Determining Trajectory to Predict Injury: The Use of X-Ray During Resuscitation in Gunshot Wounds

“…19,20 The use of CT scan to determine trajectory of bullets has been recognized since the 1980s. 21 Magnetic resonance imaging may also be a valuable tool in identifying structures injured by a bullet. 22 Simply relying on clinical and bedside radiographic imaging may not allow for determination between intracavitary and extracavitary trajectory of bullets and therefore threedimensional imaging might provide enough information to allow for definitive knowledge of trajectory.…”

Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey

“…Thus, CT should be performed in all patients with penetrating shrapnel injuries and particularly in patients with penetrating torso, head and neck injuries. 21,26,27 Initial triage of the victims was carried out by the National Emergency Service, and the victims were subsequently transferred to the nearest hospitals, including our university hospital, five of which are Level 1 trauma centres. Severely injured patients were distributed in the Level 1 trauma centres according to their physical capacities.…”