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20 Cards in this Set
- Front
- Back
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which organ is the #1 injured in trauma
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spleen
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which organ is the #2 injured organ in trauma
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liver
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how to tell the difference between hemoperitoneum and ascites
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HU of ascites 0-15
HU of fresh unclotted blood 30-45 |
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how to identify a sentinel clot
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focal collection of clotted blood (>60 HU)
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how often is extraluminal oral contrast seen in bowel transections
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only ~14%
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indirect signs of bowel transections
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bowel wall thickening
blood in mesentary |
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commonly associated injury seen with splenic rupture
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left lower rib fx
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does liver or spleen laceration carry more risk of morbidity
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liver (although the injury itself is not as common as spleen)
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how to identify a liver lac (ie where to look?)
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liver lac runs parallel to the course of the arteries
look for hypodensities adjacent to enhancing portal veins |
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what is the most common etiology for pancreatic trauma
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penetrating trauma
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what is the most common cause of pancreatitis in a child
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child abuse --> pancreatic trauma
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clues for pancreatic trauma
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look for thickening in anterior renal fascia, and/or fluid tracking to splenic vein
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complications of pancreatic trauma
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pseudocysts
hemorrhagic pancreatitis abscess/fistula |
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CT findings that suggest bowel injury
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will not usually see contrast extrav if exam is done with oral contrast
look for fluid between bowel loops intense bowel wall enhancement with bowel wall thickening and free fluid |
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findings of shock bowel
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diffuse dilatation of sm bowel with wall thickening and increased contrast enhancement of bowel wall
IVC flattened Kidneys show intense contrast enhancement of parenchyma |
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how to determine if there si injury to the renal collecting system
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delayed images will show contrast extrav into renal sinus and medial/lateral perirenal space
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findings in shattered kidney
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multiple lacerations
no contrast excretion |
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why does thrombosis of main renal artery occur during trauma
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stretching of the renal pedicle with tearing than the less elastic intima (media and adventitia are more elastic)
intimal flap initiates thrombosis which propogates distally |
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what is the cortical rim sign
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late sign seen after renal artery thrombosis
only cortex enhances periphery of the kidney is supplied by collaterals so it will still enhance |
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2 types of bladder trauma
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intraperitoneal (20%, from blow to lower abddmen with distended bladder. bladder rupture occurs @ dome)
extraperitoneal (80%, secondary to pelvic fx. contrast leaks into retropubic space --> abdominal wall, scrotum, thich, retroperitoneam. contrast/clxn is linear and poorly defined) |
