"Penetrating abdominopelvic trauma usually occurs in the setting of gunshot and stab injuries and is associated with high morbidity and mortality. CT is the modality of choice in imaging if the patient is stable enough before surgery. The most common injuries include small bowel, large bowel, liver, spleen, and intra-abdominal vasculature1."
"though relatively uncommon, bladder injuries are best assessed with a cystogram5"
"The likely organ(s) involved largely depend on force and projectile path. Common injuries include 1,2:"
"pelvic free fluid or pre-vesical haematoma"
"US can be useful to screen for abdominopelvic free fluid in the trauma patient, performed as part of the FAST scan 3,7. A FAST scan is not used to diagnosis or exclude solid or hollow visceral injury ref."
"US can be useful to screen for abdominopelvic free fluid in the trauma patient, performed as part of the FAST scan 3,7. A FAST scan is not used to diagnosis or exclude solid or hollow visceral injury ref."
"US can be useful to screen for abdominopelvic free fluid in the trauma patient, performed as part of the FAST scan 3,7. A FAST scan is not used to diagnosis or exclude solid or hollow visceral injury ref."
"Solid viscera organ injury is classified using the AAST scoring scale, which can help guide assessment of extent of injury. These include 2:"
"commonly involved vessels: abdominal aortic injury, SMA, iliac arteries and veins, IVC and portal vein"
"AV fistula"
"CT is more sensitive for detecting indirect signs of intra-peritoneal violation and organ injury including 2:"
"active pooling of contrast (intra-mesenteric free fluid/blood takes polygonal shape as it pools within mesenteric sheets)"
"Penetrating thoracic trauma"
"In the case of projectiles, the extent of tissue damage depends on the kinetic energy of the foreign body and the type of tissue encountered. High kinetic energy projectiles often form a cavity as a result of forceful soft tissue damage upon initial penetration. Secondary cavitation can occur whereby a temporary cavity is formed by the initial force displacing tissues that then return back into place. This may result in transmission of force and damage to structures distant to the foreign body tract. Projectiles may ricochet, fragment or cause bony fragments that also cause diffuse damage. Tracts may also image differently to initial path due to patient position (arms above head for CT) and respiration 2."
"Less common structures injured include the gallbladder, stomach, adrenal glands, ureter and spine."
"Any foreign body tract that is adjacent to an organ should raise suspicion for injury, as temporary cavitations and shock wave forces can cause proximity damage e.g. contusion or serosal damage to bowel. Organ adjacent stranding, haematoma or pneumoperitoneum also suggest local injury."
"commonly involved vessels: abdominal aortic injury, SMA, iliac arteries and veins, IVC and portal vein"
"Contrast enhanced CT is the modality of choice for evaluating injuries in penetrating abdominopelvic trauma 7,8. Some institutions have made use of enteric contrast, however this may delay management and has become unnecessary in the setting of improved resolution of CT 2. There is evidence for the use of CT tractography, injection of contrast through entry wound, in detecting peritoneal violation for stab wounds 4."