Emergency Body CT > Trauma > Introduction


Trauma

Injury to the spleen can take the form of laceration, intrasplenic hematoma, subcapsular hematoma or infarction. Each of these etiologies displays different characteristic radiographic findings on CT. CT also identifies the extent of associated hemoperitoneum. Several classification systems for splenic injury have been constructed. One system classifies splenic injury in the following manner:

Both IV and oral contrast are typically given in trauma cases. Of these, IV contrast is more important as it allows detection of injuries to solid organs (liver, spleen, pancreas, and kidneys) that would be undetectable without contrast. Oral contrast is helpful in confirming or excluding bowel injury and to avoid confusing unopacified bowel with intrapertoneal blood.

An abdominopelvic CT obtained for trauma will typically include the lower thorax. Important pathology which can be detected at this level includes fractures (rib, sternum, spine), pneumothorax, hemothorax, lung contusion, aspiration, aortic injury and malposition of tubes or lines. It is critical for the radiologist to evaluate the lower chest before focusing attention to the abdomen. In addition, an evaluation of the scout film can provide an overview of the abdomen and those areas not visualized on the axial images.

 

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