A patient with blunt trauma of abdomen at 48 hours, USG shows normal, but patient had tenderness in Left lumbar region. Best appropriate diagnosis is by (Recheck):
Correct Answer: CECT abdomen
Description: Ans. c. CECT abdomenDIAGNOSIS FOR ABDOMINAL BLUNTTRAUMADiagnosis can be quickly access by utilizing the "FAST" exam: Focused Abdominal Sonography for Trauma.Bedside U/S evaluates the perisplenic space, perihepatic space, pericardium, and pelvis for free fluid.In these locations fluid is not typically present, therefore in combination with a clinical suspicion such as hypotension following blunt trauma, should trigger the consideration of an internal injury.For an unstable patient with these findings should be taken to the OR for immediate surgical exploration.USG is used to diagnose intra-abdominal injuries in unstable patients.For a stable patient in whom the diagnosis is less definite should be taken for a more definitive study, i.e., CT scan with intravenous contrast. CT will reveal the presence of intra-abdominal fluid and can accurately delineate the source, typically the liver or spleen.CECT is used to diagnose intra-abdominal injuries in unstable patients.Extra MileMost common organ injuries in blunt trauma: SpleenMost common organ injured in penetrating trauma: Liver (26.1%)> Stomach (17.6-17.3%)> Small Intestine (12.9%)Colon and Rectal injury most common in: Penetrating trauma > blunt traumaMost common gastric injury: Penetrating trauma
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