MDCT of Abdominal Trauma

Trauma is a significant public health problem, representing the third leading cause of death in the United States. Trauma is also the leading cause of mortality in Americans under the age of 40. With the widespread availability of multidetector-row computed tomography (MDCT) in trauma centers, the traditional workup of trauma patients has changed. Blunt chest injuries are now frequently studied with MDCT to evaluate the aorta, and workup of the blunt trauma victim with abdominal injury is evolving with MDCT. MDCT now allows not only the detection of injuries but provides new information on the severity of injuries with improved detection of vascular injury manifested by “active extravasation.” Until recently, patients with a history of penetrating trauma went directly to the operating room for surgical therapy without preoperative imaging. Today, MDCT is often performed in patients with penetrating trauma in order to best identify vascular injuries prior to surgical intervention. This chapter reviews the technique of MDCT and discusses major findings in abdominal MDCT in the trauma patient. The varied manifestations of bleeding are emphasized. Common mistakes and pitfalls in interpretation are described along with a step-by-step technique for interpretation.