Gastric blunt traumatic injuries: A computed tomography grading classification

• 作者: Antonio Solazzo Francesco Lassandro Giulia Lassandro
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 胃的损害 弄钝损伤 分级的计算断层摄影术 紧急情况辐射学 胃破裂
• 年，卷（期）: 2017,（2）
• 页码范围: 85-90
• 页数: 6页
• 分类号: R656.6

摘要

AIM To produce a radiological grading of gastric traumatic injuries. METHODS In our study, we retrospectively analyzed 32 cases of blunt gastric traumatic injuries and compared computed tomography(CT) data with patients’ surgical or medical development. In all cases, a basal phase was acquired, and an intravenous contrast material was administered via an antecubital venous catheter with acquisition in the venous phase(70-90 s). In addition, a further set of delayed scans was performed 4-5 min after the first scanning session, without supplementary intravenous contrast material, to identify or better define areas of active bleeding. All CT examinations were retrospectively reviewed by two radiologists, with more than 5 years of experience in emergency radiology, to detect signs of gastric injuries and/or associated abdominal lesions according to literature data. Specific CT findings for gastric rupture include luminal content extravasation and discontinuity of the gastric wall, while CT findings suggestive of injury consisted of free peritoneal fluid, extraluminal air, pneumatosis, and thickening and hematoma of gastric wall.RESULTS We found 32 gastric traumatic injuries. In 22 patients(68.8%), the diagnosis was based on the surgical findings; in the other 10 patients(31.2%), the diagnosis was based on the clinical and CT radiological data. We observed discontinuity of the gastric wall and luminal content extravasation in 1 patient(3.1%); in 10 patients(31.2%), there was extra-luminal air in the peritoneum. In 28 patients(87.5%), there was peritoneal fluid, which was blood in 14 patients(hematoma in 11 patients and contrast material extravasation from active bleeding in 3 patients). In 15 patients(46.9%), there was gastric wall thickening. In 3 patients, it was possible to identify a prevalent involvement of the external layer of the gastric wall, whereas, in 2 patients, the inner side of the gastric wall presented with major involvement. In 3 patients(9.4%), pneumatosis of the gastric wall was detected. In 19(5