Document Detail

Spiral computed tomography with three-dimensional reconstructions for severe blunt abdominal traumas: a useful complementary tool?
MedLine Citation:
PMID:  9228449     Owner:  NLM     Status:  MEDLINE    
Spiral computed tomography (CT) has proved to be a valuable tool by providing three-dimensional (3D) images of the studied structures. We hypothesized that a more realistic depiction of lesions by 3D CT could be of interest for surgeons who are treating blunt abdominal traumas and lead to less inappropriate triage. A good working relationship between surgeons and radiologists allowed us to perform a 3D CT examination in six patients. In the first patient, the 3D CT accurately demonstrated spleen fragmentation without devascularized fragment. The second patient had complete devascularization of the spleen upper pole. Conservative treatment was pursued for both patients. For the third patient, 3D CT helped us to differentiate peritoneal-perisplenic fluid from subcapsular fluid. The fourth patient had minor spleen injury associated with severe lacerations of the left kidney. 3D CT showed a complete separation of the kidney lower pole. A delayed partial lower nephrectomy was performed. The fifth patient presented a fragmented spleen and transient massive haematuria related to a well-contained laceration of the kidney upper pole that were amenable to nonoperative management. The sixth patient was emergency operated for active bleeding from a fragmented spleen. 3D CT performed 2 months after spleen repair allowed the assessment of the amount of devascularized tissue, as well as the status of the upper abdomen arteries. For haemodynamically stable patients, 3D CT could be a helpful addition to conventional axial CT for quantifying blunt abdominal traumas, for making the choice between nonoperative and operative treatment, but also between emergency and delayed surgical strategy.
L A Michel; M Lacrosse; L Decannière; A Rosière; P Vandenbossche; J P Trigaux
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  4     ISSN:  0969-9546     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-09-15     Completed Date:  1997-09-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  87-93     Citation Subset:  IM    
University of Louvain School of Medicine at Mont-Godinne University Hospital, Yvoir, Belgium.
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MeSH Terms
Abdominal Injuries / radiography*
Aged, 80 and over
Child, Preschool
Emergency Medicine
Injury Severity Score
Middle Aged
Multiple Trauma / radiography*
Reproducibility of Results
Tomography, X-Ray Computed / methods,  standards*
Wounds, Nonpenetrating / radiography*

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