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Congress: ECR25
Poster Number: C-12272
Type: Poster: EPOS Radiologist (educational)
Authorblock: C. M. Saraiva, R. M. Sousa, B. M. Silva, C. V. Gonçalves, H. M. Gomes, J. P. R. Monteiro, P. M. R. C. Patrão, A. A. P. Almeida; Viseu/PT
Disclosures:
Carlos Miguel Saraiva: Nothing to disclose
Rita Marques Sousa: Nothing to disclose
Beatriz Marques Silva: Nothing to disclose
Catarina Vale Gonçalves: Nothing to disclose
Helena Martins Gomes: Nothing to disclose
João Pedro Rodrigues Monteiro: Nothing to disclose
Pedro Miguel Ribau Costa Patrão: Nothing to disclose
Antonio Angelo Peres Almeida: Nothing to disclose
Keywords: Abdomen, Trauma, CT, Diagnostic procedure, Acute, Trauma
Learning objectives To review and illustrate CT (Computed Tomography) imaging findings in the context of blunt abdominal trauma, including injuries to solid abdominal viscera, bowel and mesentery, the abdominal wall and diaphragm. To review the 2018 American Association for the Surgery of Trauma (AAST) Organ Injury Scale for the liver, kidney and spleen.
Read more Background Traumatic injuries constitute nearly 8% of worldwide deaths, with a third of these resulting from road traffic accidents.Hemodynamically stable patients usually undergo a Focused Assessment with Sonography for Trauma (FAST) scan exam, which aims to identify intraperitoneal fluid and, if possible, parenchymal lesions. If the initial FAST ultrasound yields a positive result, the patient undergoes a CT scan.
Read more Findings and procedure details CT ProtocolAn appropriate CT protocol is essential to accurately depict organ injuries resulting from abdominal trauma. Historically, the standard trauma protocol has included a sing portal venous phase acquisition performed 65–80 seconds after intravenous injection of contrast, but the 2018 AAST Injury Scale advocates for the use of dual-phase CT (arterial and portal venous phases). Images should be reviewed by the radiologist to decide whether a delayed venous phase is needed (to exclude renal collecting system injury, for example). Delayed...
Read more Conclusion The radiologist should be aware that appropriate grading according to the latest AAST scales plays a critical role in the setting of traumatic injury, by allowing correct management of the patient in the emergency department.Most of these injuries can be managed with supportive treatment, but more invasive treatment may be needed whether it’s surgery or embolization.
Read more References Dixe de Oliveira Santo, I. et al. (2023) ‘Grading abdominal trauma: Changes in and implications of the revised 2018 AAST-OIS for the spleen, liver, and kidney’, RadioGraphics, 43(9). doi:10.1148/rg.230040. Soto, J.A. and Anderson, S.W. (2012) ‘Multidetector CT of blunt abdominal trauma’, Radiology, 265(3), pp. 678–693. doi:10.1148/radiol.12120354. Hosein, M. et al. (2019) ‘Coming together: A review of the American Association for the surgery of trauma’s updated kidney injury scale to facilitate multidisciplinary management’, American Journal of Roentgenology, 213(5), pp....
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