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Blunt abdominal trauma

Case Study
Dr. Jonathan Hack Sunninghill Hospital

Patient history and symptoms

This young lady was involved in a motor vehicle accident, sustaining blunt abdominal trauma. She presented with a tender abdomen, but was under the influence of alcohol and was thus difficult to assess.

Contrast

type: Ultravist 300

injection rate: 2.5 ml per second

total volume: 150 ml

route: antecubital vein

bolus timing: 70 seconds delay

Imaging parameters

  • 250 mAs/slice
  • 120 kVp
  • 0.824 pitch
  • 370 mm FOV
  • 40 X 0.625 mm collimation
  • 0.5 seconds per rotation
  • 0.9 mm x 0.45 mm reconstruction
  • Filter: B
  • 11.88 second scan time
 Coronal MPR demonstrating the presence of free air. Axial image demonstrating the presence of free intra-abdominal air and fluid. Coronal MPR demonstrating the presence of free fluid as well as the gastric defect.
Coronal MPR demonstrating the presence of free air.
Axial image demonstrating the presence of free intra-abdominal air and fluid.
Coronal MPR demonstrating the presence of free fluid as well as the gastric defect.
 Curved coronal volume rendered images demonstrating the free 
fluid and gastric defect. Curved coronal volume rendered images demonstrating the free 
fluid and gastric defect.
Curved coronal volume rendered images demonstrating the free fluid and gastric defect.
Curved coronal volume rendered images demonstrating the free fluid and gastric defect.

Significant findings

The CT demonstrated the presence of a defect in the distal aspect of the lesser curvature of the stomach. There was extensive free intra-peritoneal fluid and air. There was no other intra-abdominal injury.

How did CT make a difference in the diagnosis and treatment?

Faced with a non co-operative patient, I was able to assess the patient's abdomen rapidly and accurately, identifying this rather unusual injury. A CT of the head and cervical spine was also done. This was normal. The patient was promptly transferred to the OR, where the surgeon confirmed the presence of a 15 centimeter long gastric tear.


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Jan 27, 2006

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Case Study
Brilliance 40-channel
abdomen, Body, bolus tracking, Brilliance v2.0, motor vehicle accident, MPR, trauma
 

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