Trauma of the Abdomen and Pelvis

  • Philip J. Kenney
  • Stuart E. Mirvis


Trauma is a major health problem in all age groups but it is especially true in the young, due to high-velocity transportation, altercations, including with weapons and resulting in penetrating injuries, as well as falls and sportsrelated injuries. In addition, both the elderly and pregnant women are vulnerable to trauma. Improvements in the management of trauma include more rapid rescue, better organization of trauma centers, and advances in treatment. Current trends include increased non-operative management of trauma-related injuries, accurate imagingbased diagnosis, and greater emphasis on the efficient but cost-effective use of imaging. One aspect of the trend to non-operative care is the desire to avoid non-therapeutic surgery; this is possible if imaging can identify those patients who require surgery. Another is the realization that non-operative care can result in better long-term outcome, such as splenic salvage.


Pelvic Fracture Bowel Injury Splenic Injury Bladder Injury Urethral Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Novelline RA, Rhea JT, Bell T (1999) Helical CT of abdominal trauma. RCNA 37:591–612CrossRefGoogle Scholar
  2. 2.
    Dolich MO, McKenney MG, Varela JE et al (2001) Ultrasounds for blunt abdominal trauma. J Trauma 50:108–112CrossRefPubMedGoogle Scholar
  3. 3.
    Shapiro MJ, Krausz C, Durham RM et al (1999) Overuse of splenic scoring and computed tomographic scans. J Trauma 47:651–658CrossRefPubMedGoogle Scholar
  4. 4.
    Goodwin H, Holmes JF, Wisner DH (2001) Abdominal ultrasound examination in pregnant blunt trauma patients. J Trauma 50:689–693CrossRefPubMedGoogle Scholar
  5. 5.
    Lowdermilk C, Gavant ML, Qaisi W et al (1999) Screening helical CT for evaluation of blunt traumatic injury in the pregnant patient. Radiographics 19:S243–255. Kenney PJ Invited commentary S256Google Scholar
  6. 6.
    McGahan JP, Richards JR, Jones CD et al (1999) Use of ultrasonography in the patient with acute renal trauma. JUM 18:207–213Google Scholar
  7. 7.
    Kawashima A, Sandler CM, Corl FM et al (2001) Imaging of renal trauma: a comprehensive review. Radiographics 221: 557–574Google Scholar
  8. 8.
    Ortega SJ, Netto FS, Hamilton P et al (2008) CT scanning for diagnosing blunt ureteral and uretropelvic junction injuries. BMC Urology 8:3–7CrossRefPubMedGoogle Scholar
  9. 9.
    Santucci RA, McAninch JW, Safir M et al (2001) Validation of the American Association for the Surgery of Trauma organ injury severity scale for the kidney. J Trauma 50:195–200CrossRefPubMedGoogle Scholar
  10. 10.
    Goldman SM, Sandler CM, Corriere JN et al (1997) Blunt urethral trauma: a unified anatomical mechanical classification. J Urol 157:85–89CrossRefPubMedGoogle Scholar
  11. 11.
    Morgan DM, Nallamalla LK, Kenney PJ et al (2000) CT cystography: radiographic and clinical predictors of bladder rupture. AJR 174:89–95PubMedGoogle Scholar
  12. 12.
    Quagliano PV, DeLair SM, Malhotra AK (2006) Diagnosis of blunt bladder injury: a prospective comparative study of CT Cystography and conventional retrograde cystography. J Trauma 61:410–422CrossRefPubMedGoogle Scholar
  13. 13.
    Chan DPN, Abujudeh HH, Cushing GL et al (2006) CT Cystography with multiplanar reformation for suspected bladder rupture. AJR 187:1296–1302CrossRefPubMedGoogle Scholar
  14. 14.
    Malhotra AK, Fabian TC, Katsis SB et al (2000) Blunt bowel and mesenteric injuries: the role of screening CT. J Trauma 48:991–998CrossRefPubMedGoogle Scholar
  15. 15.
    Butela ST, Federle MP, Chang PJ et al (2001) Performance of CT in Detection of bowel injury. AJR 176:129–135PubMedGoogle Scholar
  16. 16.
    Atri M, Hanson JM, Grinblat L et al (2008) Surgically important bowel and or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation. Radiology 249:524–533CrossRefPubMedGoogle Scholar
  17. 17.
    West OC (2000) Intraperitoneal abdominal injuries. ARRS Categorical course syllabus. ARRS, Reston, VA, p 87Google Scholar
  18. 18.
    Davis KA, Fabian TC, Croce MA et al (1998) Improved success in nonoperative management of blunt splenic injuries: embolisation of splenic artery pseudoaneurysms. J Trauma 44:1008–1013CrossRefPubMedGoogle Scholar
  19. 19.
    Peitsman AB, Heil B, Rivera L et al (2000) Blunt splenic injury in adults: multi-institutional study of the Eastern Association for the Surgery of Trauma. J Trauma 49:177–187CrossRefGoogle Scholar
  20. 20.
    Cohn SM, Arango JL, Myers JG et al (2009) Computed tomography grading systems poorly predict the need for intervention after spleen and liver injuries. American Surgeon 75:133–139PubMedGoogle Scholar
  21. 21.
    Gavant ML, Schurr M, Flick PA et al (1997) Predicting clinical outcome of nonsurgical management of blunt splenic injury: using CT to reveal abnormalities of splenic vasculature. AJR 168:207PubMedGoogle Scholar
  22. 22.
    Anderson SW, Varghese JC, Lucey BC et al (2007) Blunt splenic trauma: delayed phase CT for differentiation of active hemorrhage from contained vascular injury in patients. Radiology 243:88–95CrossRefPubMedGoogle Scholar
  23. 23.
    Richards JR, McGahan JP, Pali MJ et al (1999) Sonographic detection of blunt hepatic trauma. J Trauma 47:1092–1097CrossRefPubMedGoogle Scholar
  24. 24.
    Yoon W, Jeong YY, Kim JK et al (2005) CT in blunt liver trauma. Radiographics 25:87–104CrossRefPubMedGoogle Scholar
  25. 25.
    Fang J-F, Wong Y-C, Lin B-C et al (2006) CT risk factors for the need of operative treatment in initially hemodynamically stable patients after blunt hepatic trauma. J Trauma 61:547–554CrossRefPubMedGoogle Scholar
  26. 26.
    Wittenburg A, Minotti AJ (2005) CT diagnosis of traumatic gallbladder injury. AJR 185:1573–1574CrossRefGoogle Scholar
  27. 27.
    Sinelnikov AO, Abujudeh HH, Chan D, Novelline RA (2007) CT manifestations of adrenal trauma: experience with 73 cases. Emerg Radiol 13:313–318CrossRefPubMedGoogle Scholar
  28. 28.
    Linsenmaier U, Wirth S, Reiser M et al (2008) Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics 28:1591–1601CrossRefPubMedGoogle Scholar
  29. 29.
    Phelan HA, Velmahos GC, Jurkovich J et al (2009) An evaluation of multidetector CT in detecting pancreatic injury: results of a multicenter AAST study. J Trauma 66:641–647CrossRefPubMedGoogle Scholar

Copyright information

© Springer Verlag Italia 2010

Authors and Affiliations

  • Philip J. Kenney
    • 1
  • Stuart E. Mirvis
    • 2
  1. 1.University of Arkansas for Medical SciencesLittle RockUSA
  2. 2.University of Maryland School of MedicineBaltimoreUSA

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