American Journal of Roentgenology, Vol 160, 1221-1223, Copyright © 1993 by American Roentgen Ray Society

ARTICLES

Duodenal injuries caused by blunt abdominal trauma: value of CT in differentiating perforation from hematoma

JR Kunin, M Korobkin, JH Ellis, IR Francis, NM Kane and SE Siegel
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109-0030.

OBJECTIVE. Traumatic duodenal perforation requires emergent surgery, whereas duodenal hematoma can often be treated nonsurgically. We assessed the CT findings in patients with blunt duodenal trauma to determine if CT can be used to differentiate these two duodenal injuries. MATERIAL AND METHODS. Seven consecutive patients with blunt duodenal trauma (three with perforation, four with hematoma) who underwent CT as part of their initial diagnostic evaluation were included in the study. All three perforations and one of four hematomas were surgically proved. Diagnoses of duodenal hematoma in the other three patients were based on typical features on upper gastrointestinal studies and complete resolution of clinical findings after conservative treatment. The CT scans were retrospectively reviewed without knowledge of the specific type of duodenal injury, and the findings were correlated with the results of the gastrointestinal studies and surgical findings. RESULTS. CT showed extraluminal gas or extravasated oral contrast material or both in the right anterior pararenal space in all three patients with duodenal perforation and in none of the patients with duodenal hematoma. Thickening of the duodenal wall and fluid in the right anterior pararenal space were seen in both groups of patients. CONCLUSION. Although the number of patients in the study was small, the results suggest that CT may be useful in differentiating duodenal perforation from hematoma without perforation. Extraluminal gas or extravasated oral contrast material or both were seen in the right anterior pararenal space in all three patients who had perforation and in none of the patients who had hematoma alone.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. J. Lonergan, A. M. Baker, M. K. Morey, and S. C. Boos From the Archives of the AFIP: Child Abuse: Radiologic-Pathologic Correlation RadioGraphics, July 1, 2003; 23(4): 811 - 845. [Abstract] [Full Text] [PDF]

				R Zissin, A Osadchy, G Gayer, and M Shapiro-Feinberg CT of duodenal pathology Br. J. Radiol., January 1, 2002; 75(889): 78 - 84. [Abstract] [Full Text] [PDF]

				J. M. Brody, D. B. Leighton, B. L. Murphy, G. F. Abbott, J. P. Vaccaro, L. Jagminas, and W. G. Cioffi CT of Blunt Trauma Bowel and Mesenteric Injury: Typical Findings and Pitfalls in Diagnosis RadioGraphics, November 1, 2000; 20(6): 1525 - 1536. [Abstract] [Full Text] [PDF]

				P. J. Strouse, B. J. Close, K. W. Marshall, and R. Cywes CT of Bowel and Mesenteric Trauma in Children RadioGraphics, September 1, 1999; 19(5): 1237 - 1250. [Abstract] [Full Text] [PDF]

				R. E. Stafford, M. D. McGonigal, J. A. Weigelt, and T. J. Johnson Oral Contrast Solution and Computed Tomography for Blunt Abdominal Trauma: A Randomized Study Arch Surg, June 1, 1999; 134(6): 622 - 627. [Abstract] [Full Text] [PDF]