Abdominal Trauma 15818.jpg
Splenic Injuries

Hepatic injuries

Renal injuries

Pancreatic injury

Bowel injury

CT IS DONE WITH CONTRAST

Splenic injuries

(I) Superior location & subcapsular hematoma < 1 cm

(II) 1-3 cm deep laceration & subcapsular hematoma < 3 cm

(III) Laceration > 3 cm deep & subcapsular hematoma > 3 cm

(IV) Fragmentation > 3 cm pieces & No enhancement "Shattered or fractured spleen"

Hepatic injuries ( grading is like the splenic trauma )

*NCCT >>> Hemorrhage : Hyper

*CECT >>> Hypo as the organ enhance but the hematoma NOT

Renal injury

(I) Contusion , superior laceration , small perinephric or subcapsular hematoma "medical treatment"

(II) Laceration < 1 cm deep with perinephric hematoma

(III) Laceration extending into the collecting system with perinephric hmatoma

"medical / surgical"

OR :

Laceration > 1 cm deep with perinephric hematoma or massive or expanding

hematoma ( 95 % following biopsy , large hematoma within the gerotta's fascia )

N.B. >>> take the biopsy from the lower pole

(IV) Avulsion of the renal pedicle with intact kidney "surgery"

C.M. >>>> one kidney excrete the contrast and the other NO

(V) Shattered kidney

Pancreatic injury

If traumatized >>> post traumatic pancreatitis >>> more common in children
Bowel injury

CT signs :

*Free intraperitoneal air

*Extravasation of C.M.

*Intraperitoneal fluid of unknown origin

*Thickened bowel wall & enhanced > 4 mm

*Mesenteric wall hematoma

Prof Dr Mamdouh Mahfouz