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Aim: The aim of our study was to analyze the role of Multidetector computed Tomography (MDCT) in the classification and management of high energy blunt abdominal trauma. Material And Method: A Prospective study of 140 patients of all age groups was conducted from October 2010 to October 2012. Rectal and IV contrast were used. Angiography was performed in cases of suspected vascular trauma. Three dimensional reconstructions were done. CT findings were correlated and confirmed by either operative findings or follow-up CT. Result: 140 cases of blunt abdominal trauma were included in this study. Abdominal USG (Ultrasound) and MDCT were performed. Abdominal injuries were more common in males seen in 119 cases (89%). Spleen was the most common organ to be injured, affected in 40 patients (23%). Liver injury was seen in 36 cases, renal involvement in 30 cases, bowel in 20 cases, urinary bladder in 7 cases, a pancreatic injury in 3 cases and retro peritoneum involvement in 2 cases. Out of 140 patients 135 had free intraperitoneal fluid. USG findings and MDCT findings were compared with per operative findings. Patients managed conservatively were compared with repeat follow up CT findings. USG showed a sensitivity of 55 % and specificity of 75 % in solid organs injury and sensitivity of 95 % and specificity of 99 % in free fluid detection. MDCT showed a sensitivity of 97 % and specificity of 98 % in solid organs injury and 100%in hemoperitoneum. Conclusion: MDCT is the modality of choice to evaluate abdominal injury when there is doubt in clinical and USG findings, and to offer patient conservative management. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the role of multidetector computed tomography (MDCT) in detecting and classifying the large bowel lesions. A prospective study of 100 adult patients was conducted from June 2007 to October 2009. Rectal and IV contrast were used for three dimensional reconstruction. Angiography was performed in cases of suspected ischemic pathology. CT colongraphy was done to evaluate adenomas. CT findings were correlated and confirmed by either colonoscopy, biopsy, postoperative findings or follow-up CT. The pathologies were common in 50-70 yrs (44%). M: F ratio was 2:1. Malignant lesions were seen in (55%) followed by inflammatory lesions in 26%, diverticulitis and ischemic colitis in 6% each. Miscellaneous conditions like polyps, volvulus and intussusceptions were seen in 7%. Adenocarcinoma was the common malignancy (81.2%). Present study showed that adenocarcinomas were associated with marked thickening of bowel wall (>1.5 cm) in 85.4% of patients, asymmetrical wall thickening (96.4%), focal involvement (length <10 cm) in 85.5% with heterogeneous post contrast enhancement (96.3%). Inflammatory lesions showed mild thickening (69%),segmental or diffuse involvement (77%), symmetrical wall thickening (89%) and homogenous post contrast enhancement (81%). Ischemic lesions showed marked thickening (83.4%), symmetrical thickening (100%) and homogenous enhancement (100%). Diverticulitis showed marked thickening (100%), asymmetrical wall thickening (66.7%) with heterogeneous post contrast enhancement (100%), with pericolic fluid. Arterial/venous thrombosis was diagnosed in 66.66%. Three per cent had benign adenomatous polyps on CT colonographic studies. MDCT was accurate in 98.2% cases for differentiating between benign and malignant etiology and is the modality of choice. [ABSTRACT FROM AUTHOR]