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Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries.
- Source :
-
Radiographics : a review publication of the Radiological Society of North America, Inc [Radiographics] 2019 Jul-Aug; Vol. 39 (4), pp. 1183-1202. - Publication Year :
- 2019
-
Abstract
- After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient's condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24-48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients. Online supplemental material is available for this article. <superscript>©</superscript> RSNA, 2019 See discussion on this article by LeBedis .
- Subjects :
- Abdominal Injuries surgery
Abdominal Wound Closure Techniques
Artifacts
Emergencies
Female
Foreign Bodies diagnostic imaging
Foreign Bodies surgery
Hemorrhage etiology
Hemorrhage therapy
Hemostatic Techniques instrumentation
Humans
Hypothermia etiology
Hypothermia therapy
Intra-Abdominal Hypertension diagnostic imaging
Laparotomy
Male
Pelvis injuries
Pelvis surgery
Resuscitation
Shock diagnostic imaging
Wounds, Gunshot diagnostic imaging
Wounds, Gunshot surgery
Wounds, Nonpenetrating diagnostic imaging
Wounds, Nonpenetrating surgery
Wounds, Penetrating diagnostic imaging
Wounds, Penetrating surgery
Abdominal Injuries diagnostic imaging
Multidetector Computed Tomography methods
Pelvis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1527-1323
- Volume :
- 39
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Radiographics : a review publication of the Radiological Society of North America, Inc
- Publication Type :
- Academic Journal
- Accession number :
- 31283454
- Full Text :
- https://doi.org/10.1148/rg.2019180153