Active Bleeding in Computed Tomography in Abdominal Trauma

Abstract

Trauma is the leading cause of death in people under the age of 40; in which abdominal trauma associated with bleeding is the cause of death in 40% of the cases. Multidetector Computed Tomography (MDCT) with intravenous contrast has high sensitivity to detect intraabdominal active bleeding, being embolization a top-rated tool in nonsurgical hemostatic management of traumatized patients.

The objectives were to demonstrate the prevalence of Active Bleeding by MDCT with intravenous contrast in patients who presented abdominal trauma. To quantify the relation between Active Bleeding and the injury of a specific organ. To assess the number of patients treated by embolization for therapeutic purposes.

We carried out a retrospective, cross- sectional, descriptive study of 417 patients with abdominal trauma and MDCT in the HUM in Córdoba. The inclusion criteria were: age over 16 with active bleeding in MDCT due to abdominal trauma. General prevalence and its relation to different variables (sex, age, affected organ, and embolization) were evaluated. Quantitative data are presented as Mean +/- standard deviation and percentages. Qualitative data are the various organs injured by abdominal trauma and its greater implication in men compared to women.

The 26 patients, with an age of 29, 63 +/-9.9 years old, a range of 17-52 years, met the inclusion criteria. 20 patients (78%) were males and 65% of the total presented blunt abdominal trauma. The general prevalence of active bleeding in MDCT by abdominal trauma was 6.3%, being the kidney the most affected organ with 7 cases (27%). It was necessary to carry out embolization in 17 patients (65.3%).

MDCT in abdominal trauma allows detecting active bleeding quickly and accurately, and it also enables to identify the origin of bleeding and the injured organ. In our experience, the prevalence of active bleeding was 6.23%. The most frequently injured organ was the kidney with 27% and in frequency order were intestinal, mesenteric and splenic injuries. Embolization was used as a hemostatic technique in 65.3% of the patients with active bleeding