The role of multidetector computed tomography versus digital subtraction angiography in triaging care and management in abdominopelvic trauma

Singapore Medical Journal
James Thomas Patrick Decourcy HallinanUei Pua

Abstract

This study aimed to assess the ability of contrast-enhanced computed tomography (CECT) to detect active abdominopelvic haemorrhage in patients with blunt trauma as compared to digital subtraction angiography (DSA). In this retrospective study, patients who had DSA performed within 24 hours following CECT for blunt abdominal and/or pelvic trauma were identified. The CT trauma protocol consisted of a portal venous phase scan without CT angiography; delayed phase study was performed, if appropriate. All selected CECT studies for the presence of active extravasation of contrast were independently reviewed by two radiologists, who were blinded to the DSA results. Fisher's exact test was used to correlate the presence of extravasation on CT with subsequent confirmed haemorrhage on DSA. During the 8-year study period, 51 patients who underwent emergent DSA for abdominal or pelvic trauma also underwent prior CECT. Evidence of active extravasation of contrast on CECT was observed in 35 patients, and active haemorrhage was confirmed on DSA in 31 of these 35 patients; embolisation was performed in all 31 patients. Two patients who were negative for active extravasation of contrast on CECT, but positive for active haemorrhage on DSA had ex...Continue Reading

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Citations

Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Jul 21, 2020·Emergency Radiology·Johannes Clemens GodtJohann Baptist Dormagen

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