PubMed HealthSearch

PubMed · 6856833

Hemoperitoneum studied by computed tomography.

Abstract

Three hundred patients who had sustained blunt abdominal injury were evaluated with computed tomography (CT). The images showed areas of hemorrhage by varying attenuation coefficients (average, 45 Hounsfield units; exceeding 30 Hounsfield units in all cases except in those patients with bleeding more than 48 hours old). Small hematomas tended to accumulate near the site of origin while free intraperitoneal bleeding most frequently accumulated in the Morison pouch, paracolic gutters, and pelvis. CT estimates of the extent of hemoperitoneum (small, moderate, or large) correlated well with clinical assessments and surgical findings. Only one false-negative and two false-positive CT interpretations occurred, and each was potentially avoidable in retrospect. CT is sensitive and specific for the diagnosis of hemoperitoneum and can estimate the extent and probable source of bleeding. This information may obviate the need for a peritoneal lavage and laparotomy in many instances.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M P Federle, R B Jeffrey. 1983. Hemoperitoneum studied by computed tomography.. https://doi.org/10.1148/radiology.148.1.6856833

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Intravascular stenting of traumatic abdominal aortic dissection.

PURPOSE: We describe the case of a 34-year-old man with blunt abdominal trauma. Initial abdominal computed tomography scan showed retroperitoneal hematoma, pancreatic contusion, multiple fractures of the transverse process in the thoraco-lumbar spine, and infrarenal aortic dissection. METHOD: Angiography revealed that the aortic dissection originated proximal to the inferior mesenteric artery and extended down to the left common iliac artery without vascular obliteration. The pancreatic trauma was managed without operation, and the dissection was treated with aortic and left iliac endovascular self-expanding Schneider Wall Stents. RESULT: Immediate angiographic and computed tomography scan examination showed the obliteration of the greater part of the dissection with persistence of a short dissected segment at the level of the aortic bifurcation. Examination a week later showed thrombosis of this false lumen and complete obliteration of the dissection. CONCLUSION: Intravascular stenting allowed treatment of the dissection without open surgical procedures requiring laparotomy and aortic operation.

Abdominal Injuries

The use of computed tomography in blunt abdominal injuries.

A retrospective study was performed to evaluate the use of abdominopelvic computed tomography of the abdomen (CTA) in the initial evaluation of hemodynamically stable blunt trauma patients. Two hundred fifty-six of 2,047 injury admissions over a 2-year period underwent CTA. Sixty-two (24.2%) scans were positive for visceral injury. Sensitivity of CTA for patients with visceral injury was 92.4 per cent, specificity was 99.5 per cent, and overall accuracy was 97.6 per cent. Of all injuries documented by CTA or laparotomy, CTA detected 83.7 per cent. Injury-specific sensitivities were lowest in injuries of the pancreas (0%), intestinal tract (41.6%), and bladder (50%). False negative scans occurred in 1.9 per cent of patients, with no deaths or major complications attributable to delay in diagnosis. Nonoperative management was possible in 72 per cent of 57 patients with solid viscus injuries; splenic preservation was possible in 81.5 per cent of injured organs. Urine dipsticks and urinalysis performed poorly as predictors of either significant urological injury or intra-abdominal injury in general. When indications included early need for nonabdominal operation, only three of 41 scans were positive. Yield for patients scanned with obtundation as an isolated indication was diminished. Cost of CTA exceeds that of DPL, but lower procedure-related risk and lower estimated rate of nontherapeutic laparotomy leads to clinical favor of CTA in this group of patients.

Abdominal Injuries