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ORIGINAL ARTICLE
Year : 2013  |  Volume : 3  |  Issue : 3  |  Page : 211-215

Diagnostic efficacies of computed tomography and ultrasonography in pediatric blunt abdominal trauma


1 Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
2 Department of Paediatric Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

Correspondence Address:
Navneet Redhu
H. No. T1 Azim residency, New Sir Syed Nagar, Aligarh-202 002, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.129565

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Background: Blunt abdominal trauma is a common cause of morbidity and mortality in children. The objectives of the study are to evaluate the specific patterns of organ injury in pediatric patients as illustrated by ultrasonography and computed tomographic (CT) scan and assess the role of nonoperative management in such cases depending upon the severity of injury and the organ injured. Materials and Methods: This prospective study was conducted on pediatric patients with blunt abdominal trauma that presented to the casualty of Jawaharlal Nehru Medical College over a period of 2 years. A total of 45 patients were examined. The ultrasonographic evaluation of the patients was performed and thereafter CT scan of the patients were performed within 24 h of hospital admission if on ultrasonography any evidence of intraperitoneal free fluid was detected with or without any detectable visceral organ injury. Results: Ultrasonography detected hemoperitoneum in 15 patients (51.72%) as compared to CT which detected it in 23 cases (79.31%). Spleen was the most common solid organ injured, encountered in 10 cases (34.48%) on ultrasonography and 15 cases (51.72%) on CT scan. Liver was the second most common injured organ which was demonstrated by ultrasonography in five cases (17.24%), while CT detected hepatic parenchymal injuries in nine cases (31.03%). CT was also significantly more sensitive than ultrasonography in the detection of renal injuries which were illustrated by ultrasound in only one case (3.44%), while CT showed renal injuries in three cases (10.34%). Pancreatic injuries were least common and were seen in two cases and were detected equally by ultrasound and CT scan. Conclusion: Ultrasonography is a very useful and sensitive investigation for the detection of hemoperitoneum and visceral injuries. However, CT better delineates the solid organs injuries and grades the injury as well, thus guiding the management protocol. Nonoperative management is the rule in hemodynamically stable patients in correlation with radiological and clinical scenario.


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