Blunt Liver and Spleen Injuries on the CT Image
Charvát F., Chmátal P., Lacman J.
Radiodiagnostické oddělení ÚVN, Praha, přednosta MUDr. P. Fencl, CSc. Chirurgické oddělení ÚVN, Praha, přednosta MUDr. L. Lednický |
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Summary:
In the course of 24 months (from July 1, 1996 till June 30, 1998) in the Central Military Hospital in
Prague after CT examination of the abdomen 23 patients were subjected to laparotomy or laparoscopy on account of assumed injuries of the liver or spleen. The outcome of CT is considered in the
literature as one of the essential prerequisites of possible conservative treatment of the mentioned
injuries. Their accuracy and reliability is however not unequivocal. On comparison of the CT and
surgical finding in our patients a positive CT finding was correct in 17 of 19 cases, i.e. in 89%. Four
patients were operated on account of clinical signs of intraabdominal injury, although CT was
negative. In two of them a liver injury was found in the area of the lig. falciforme. The overall
accuracy was 83%. During the second evaluation the accuracy increased to 87%. CT when classified
according to AAST underrated the injury on average by 0.45 degrees. CT of the abdomen is in the
authors opinion indicated in multiple injuries and serious associated injuries with a stable circulation as it makes it possible to examine effectively within a short time also other injured areas. It
should be always made, using contrast medium.
Key words:
CT examination - blunt injuries of the liver and spleen - laparotomy - laparoscopy
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