Recognizing the imaging findings of trauma. Flashcards
What do you see outlined by the black rim?
Pukmonary contusion. Tend to be peripherally placed. Air bronchograms not present because blood fills bronchi as well as airspaces. Appear within 6 hours after trauma and because blood in airspaces tends to reabsorb quickly disappear within 72 hours or sooner. If it lingers >72 hours, consider aspiration pneumonia or pulmonary laceration.
What is the arrow? What is the *?
Arrow: lung contusion
* : hemothorax
What happened to this patient? What is that blurry looking mass?
Pulmonary contusion with accompanying rib fx. Blurry looking amss is actually the top of the left hemidiphragm.
What do you see here?
Mediastinal hematoma (arrowheads) compressing SVC (double arrow).
What do you always need to remember when doing an abdominal CT for trauma case?
Because IV contrast is always used (unless contraindicated) in abdominal CT, you should perform head CT PRIOR to injecting contrast for abdomen.
Arrows pointing to?
Lenticular fluid collection involving lateral portion of right lobe of the liver (most common place for hematoma formation in liver) that represents a subcapsular hematoma. Note that there is also a large intrasplenic hematoma present in this pt.
What do you see?
Multiple lacerations of the right lobe of the liver.
What do you see?
Contrast-enhanced CT scan demonstrates high-attenuation arterial extravasation (horizontal arrows) within an intraparenchymal and a subcapsular hematoma.
How do you treat most splenic trauma?
Conservatively.
What happened to this pt?
Multiple lacerations of left kidney.
What happened here? What is the black arrow pointing to?
This is shock bowel, which occurs with blunt abdominal trauma in which there is severe hypovolemia and profound hypotension with complete reversibility of these findings following resuscitation. Also note the patienth has fluid in the retroperitoneum (black arrow). There is diffuse thickening of small bowel with increased enhancement along with fluid-filled and dilated loops of bowel.
What happened to this pt?
Contrast cntaining urine has leaked into extraperitoneal spaces after being instilled into a perforated bladder following pelvic fx. This is an EXTRAperitoneal bladder rupture (more common).
What happened to this pt?
Intraperitoneal bladder rupture – less common, may occur with blunt trauma to a full/distended bladder (esp. in children). Usually occurs at DOME of the bladder.
