Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries

Lauren F. Alexander, Tarek N. Hanna, Jordan D. Legout, Manohar S. Roda, Joseph G. Cernigliaro, Pardeep Kumar Mittal, Peter A. Harri

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient’s condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24–48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.

Original languageEnglish (US)
Pages (from-to)1183-1202
Number of pages20
JournalRadiographics
Volume39
Issue number4
DOIs
StatePublished - Jul 1 2019

Fingerprint

Pelvis
Abdomen
Wounds and Injuries
Intraoperative Complications
Resuscitation
Surgical Blood Loss
Critical Care
Foreign Bodies
Artifacts
Laparotomy
Intensive Care Units
Shock
Emergencies
Hemorrhage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Alexander, L. F., Hanna, T. N., Legout, J. D., Roda, M. S., Cernigliaro, J. G., Mittal, P. K., & Harri, P. A. (2019). Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries. Radiographics, 39(4), 1183-1202. https://doi.org/10.1148/rg.2019180153

Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries. / Alexander, Lauren F.; Hanna, Tarek N.; Legout, Jordan D.; Roda, Manohar S.; Cernigliaro, Joseph G.; Mittal, Pardeep Kumar; Harri, Peter A.

In: Radiographics, Vol. 39, No. 4, 01.07.2019, p. 1183-1202.

Research output: Contribution to journalArticle

Alexander, LF, Hanna, TN, Legout, JD, Roda, MS, Cernigliaro, JG, Mittal, PK & Harri, PA 2019, 'Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries', Radiographics, vol. 39, no. 4, pp. 1183-1202. https://doi.org/10.1148/rg.2019180153
Alexander, Lauren F. ; Hanna, Tarek N. ; Legout, Jordan D. ; Roda, Manohar S. ; Cernigliaro, Joseph G. ; Mittal, Pardeep Kumar ; Harri, Peter A. / Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries. In: Radiographics. 2019 ; Vol. 39, No. 4. pp. 1183-1202.
@article{788fdaf6345c49d1bd6a2988e2c02100,
title = "Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries",
abstract = "After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient’s condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24–48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.",
author = "Alexander, {Lauren F.} and Hanna, {Tarek N.} and Legout, {Jordan D.} and Roda, {Manohar S.} and Cernigliaro, {Joseph G.} and Mittal, {Pardeep Kumar} and Harri, {Peter A.}",
year = "2019",
month = "7",
day = "1",
doi = "10.1148/rg.2019180153",
language = "English (US)",
volume = "39",
pages = "1183--1202",
journal = "Radiographics",
issn = "0271-5333",
publisher = "Radiological Society of North America Inc.",
number = "4",

}

TY - JOUR

T1 - Multidetector ct findings in the abdomen and pelvis after damage control surgery for acute traumatic injuries

AU - Alexander, Lauren F.

AU - Hanna, Tarek N.

AU - Legout, Jordan D.

AU - Roda, Manohar S.

AU - Cernigliaro, Joseph G.

AU - Mittal, Pardeep Kumar

AU - Harri, Peter A.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient’s condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24–48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.

AB - After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient’s condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24–48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.

UR - http://www.scopus.com/inward/record.url?scp=85069285670&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069285670&partnerID=8YFLogxK

U2 - 10.1148/rg.2019180153

DO - 10.1148/rg.2019180153

M3 - Article

VL - 39

SP - 1183

EP - 1202

JO - Radiographics

JF - Radiographics

SN - 0271-5333

IS - 4

ER -