Diagnosis Value of abdominopelvic CT scan with intravenous contrast in patients with blunt abdominal trauma

Abstract

Trauma is one of the main causes of mortality and disability in developing countries. Traumatic patients are the predominant part of the patients referred to the emergency department of hospitals, and about 7% to 10% of trauma deaths are due to intra-abdominal injuries. Considering the controversy in literature regarding the use of CT scans with oral contrasts in diagnosis of intra-abdominal injuries, we aimed to compare the results of CT scans of the abdomen and pelvis with intravenous contrast versus oral intravenous contrast in diagnosis of intra-abdominal injuries in patients with blunt abdominal trauma who were referred to Imam Reza teaching hospital of Tabriz.

Methods & Materials: This cross-sectional descriptive-analytic study was performed over a number of 200 patients with blunt abdominal trauma who were referred to emergency department of Imam Reza teaching hospital during 2017-2018. First, intracranial hematopoietic CT scans were performed for all patients, then oral contrasts were started for each of them, and the second CT scans with oral contrasts were performed for them. Finally, the results of intravenous CT scans with oral and intravenous contrasts were considered as the reliable diagnosis and the results of intravenous CT scans were compared with them. Results: In this study, 175 men and 25 women with an average age of 31.4 ± 14.3 years old were studied. The mechanisms of trauma in 52.5%, 27%, 15% and 5.5% of them were traffic crashes, fall, fight and others, respectively. Also 21 patients died due to severity of injuries. Abdominal free fluid (32.5%), spleen injury (25.3%), liver injury (18.7%), and kidney injury (11.4%) were the most frequent types of abdominal-pelvic lesions in patients. Abdominal and pelvic CT scans with intravenous contrast showed a sensivity of 98%, a specificity of 97%, a positive predictive value of 99% and a negative predictive value of 93% in diagnosis of intra-abdominal injuries.