Role of M.D.C.T in Blunt Trauma Abdomen

The challenge in the imaging of abdominal trauma is to accurately identify injuries that require early exploration and at the same time avoid unnecessary operative intervention in cases that can be managed conservatively. To ascertain degree of trauma, a rapid, cost effective, safe and reproducible investigation used is ultrasonography. However limited information by USG limits its role in trauma. The advent of Multi Detector Computed Tomography (MDCT) is a major advancement in evaluation of patients of abdominal trauma by offering decreased scanning time, increased resolution owing to thinner collimation and reduced partial volume and motion artefacts. The aim of the present study was to assess role of Multi detector computed tomography (M.D.C.T) in evaluation of patients of blunt abdominal trauma and to assess the utility of multi planar reformations (MPR), maximum intensity projections (MIP) and 3-D reconstruction in patients of blunt trauma abdomen. At the outset of the study, a detailed history was taken, general physical examination and relevant local examination findings were recorded. Relevant laboratory examination findings were recorded. The most common mode of injury was road traffic accident (RTA) accounting for approximately 69.5% (32/46) of cases Pattern of the injuries showed that the liver was the most commonly injured organ accounting for 34.78% (16/46) of injuries The management plan of the patients prior and after MDCT examination which was guided by demographic profile like age, clinical status of the patients; time elapsed since injury and initial sonographic findings if done was studied. The use of multi detector CT in initial triage of clinically stable patients with blunt abdominal trauma results in reduction in number of unnecessary laparotomies by 91% and helps guiding initial management in emergency department in virtually every patient with high success rate of around 95%. The MDCT grade of solid organ injury does not correlate with management plan in patients with blunt abdominal trauma. The high resolution MPR, MIP, 3-D volume rendered images not only helped in displaying complex injuries but also increased diagnostic capabilities, accuracy and shortened the reporting time. The high resolution MIP and 3-D volume rendered images gave quick and prompt diagnosis of associated vascular and bony injury.