CT IS DONE WITH CONTRAST
(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
(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"
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
If traumatized >>> post traumatic pancreatitis >>> more common in children
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
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