Abstract
An: 2010, Nr.2, Articol Nr. 12
Title: 

ROLE OF MULTIDETECTOR – ROW COMPUTED TOMOGRAPHY IN THE SELECTIVE NONOPERATIVE MANAGEMENT OF BLUNT LIVER TRAUMA

Authors: 

      I. Negoi, Al.T. Ispas, G. Lupu, Ruxandra Negoi - Anatomy Department, University of Medecine and Pharmacy “Carol Davila”, Bucharest, Romania
      S. Paun, M. Beuran - Emergency Hospital of Bucharest, Romania
      ROLE OF MULTIDETECTOR – ROW COMPUTED TOMOGRAPHY IN THE SELECTIVE NONOPERATIVE MANAGEMENT OF BLUNT LIVER TRAUMA(Abstract): Computed Tomo­­graphy(CT) has emerged as the imaging modality of choice to evaluate the hemodinamycally stable patient with blunt trauma. With the advent of multidetector CT, scanning times have progressively decreased while image resolution has incrased. Aim: The main objective of the current study was to correlate the traumatic pattern of nonoperatively approached liver injuries with CT imagistic anatomy. Method: Prospective observational study of all polytrauma patients with nonoperatively approached visceral abdominal lesions, admitted during the last 12 months to the Emergency Hospital of Bucharest. The 4 detectors–CT images of patients with blunt liver injuries were selected for a secondary evaluation. Results: Out of 33 nonperatively managed abdominal visceral inuries there were 8(24,2%) liver injuries. According to Organ Injury Scale(OIS) there were: grade I–3 patients, II–2 patients, III–1 patient and IV–2 patient. In 2 cases was performed angiography and embolization of the active bleeding lesion. The sensibility for liver injury and for hemoperitoneum was 100%. The median number of CT scans during in-hospital stay was 1 (Min–1, Max-3). We did not observed any arterial contrast extravasation. Conclusions: The modern helical CT techology has improved the speed and accuracy of the image acquisition process, wich can now be performed in hemodynamically unstable patients who might not have been able to tolerate the long scannig times of the older imaging machines. Multidetector CT scan offers a high imaging accuracy in abdominal solid trauma and play a critical role in the selection of patients for nonoperative therapy.
Key words: COMPUTED TOMOGRAPHY, NONOPERATIVE MANAGEMENT, LIVER TRAUMA
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