The Role of Computed Tomography in Blunt Abdominal Trauma

  • Om Bahadur Karki Department of Surgery, Manipal College of Medical Sciences, Pokhara, Nepal.
Keywords: blunt abdominal trauma; CT scan; FAST scan; road traffic accident.

Abstract

Introduction: Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma.

Methods: A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines.

Results: Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed.

Conclusions: In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan.

Keywords: blunt abdominal trauma; CT scan; FAST scan; road traffic accident.

References

Kumar MM, Venkataramanappa M, Venkataratnam I, Kumar
NV, Babji K. Prospective evaluation of blunt abdominal
trauma by computed tomography. Indian J Radiol Imaging
2005;15:167-73
2. Hamidi MI, Aldaoud KM, Qtaish I. The Role of Computed
Tomography in Blunt Abdominal Trauma. Sultan Qaboos
Univ Med J 2007;7(1): 41–6.
3. Vadodariya KD, Hathila VP, Doshi SM. The role of Computed
Tomography in blunt abdominal trauma as investigative
tool conducted at tertiary level hospital, Vadodara. Int J Med
Sci Public Health 2014;3:433-435.
4. Radwan MM, Abu-Zidan FM. Focussed Assessment
Sonograph Trauma (FAST) and CT scan in blunt
abdominal trauma: surgeon's perspective. Afr Health
Sci. 2006;6(3):187–190.
5. Velmahos G, Toutouzas K, Radin, et al. High success with
nonoperative management of blunt hepatic trauma: the liver
is a sturdy organ. Archives of Surgery. 2003; 138(5): 475-480.
6. Wu S-C, Chow K-C, Lee K-H, Tung C-C, Yang A, Lo C-J.
Early selective angioembolization improves success of
nonoperative management of blunt splenic injury. American
Journal of Surgery. 2007; 73(9): 897-902.
7. Mallik K, Vashisht S, Thakur S, Srivastava DN. Comparative
evaluation of ultrasonography and CT in patients with
abdominal trauma: A prospective study. Indian J Radiol
Imaging. 2000;10(4):237-43.
8. M Magray, M Shahdhar, M Wani, M Shafi, J Sheikh, H
Wani. Studying The Role Of Computed Tomography In Selective
Management Of Blunt Abdominal Trauma Patients In A Single
Tertiary Care Centre In Northern India. The Internet Journal of
Surgery. 2013;30(2).
9. Mohapatra S, Pattanayak SP, Rao KRRM, Bastia B: Options in
management of solid visceral injuries from blunt abdominal
trauma. Indian J Surg; 2003; 65: 263-268
10. Atri M, Hanson JM, Grinblat L, Brofman N, Chugtai T,
Tomlinson G: Surgically important bowel and/or mesenteric
injury in blunt trauma: accuracy of multidetector CT for
evaluation. Radiology 2008, 249(2):524-33
Published
2015-12-31
How to Cite
Karki, O. B. (2015). The Role of Computed Tomography in Blunt Abdominal Trauma. Journal of Nepal Medical Association, 53(200), 227-230. https://doi.org/10.31729/jnma.2735
Section
Original Article