Radiological Evaluation Of Abdominal Trauma Cases
Özet
Abdominal trauma is a leading cause of global mortality, classified into blunt and penetrating injuries, with multi-slice computed tomography (MSCT) and extended Focused Assessment with Sonography for Trauma (eFAST) serving as the primary modern diagnostic modalities. Initial emergency department management relies on rapid stabilization via the ABCDE assessment alongside immediate resuscitation measures. Conventional radiography remains widely available for rapid initial screening, though its diagnostic role has diminished due to low sensitivity in detecting isolated blunt trauma or free air compared to advanced tomographic techniques. Conversely, eFAST efficiently maximizes the visualization of free intraperitoneal fluid, hemorrhage, and thoracic complications like pneumothorax, effectively lowering healthcare costs and reducing time to surgery. However, eFAST cannot reliably grade solid organ injuries without significant hemoperitoneum or detect small fluid volumes. MSCT represents the gold standard for comprehensive evaluation, utilizing contrast-enhanced multiphase imaging to detect complex pancreatic, splenic, hepatic, and bowel injuries with high sensitivity. While free air detected via MSCT can predict bowel perforation, clinicians must weigh this finding against radiation risks, particularly in younger patients, by utilizing automated dose modulation. Future management will increasingly integrate artificial intelligence, machine learning, and advanced eFAST screening to refine triage and optimize patient outcomes.
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