Classification of Fang et al for Pooling of CT Contrast Material Following Blunt Hepatic Trauma

Description

Fang et al used the presence of CT contrast material pooling to classify patients following blunt hepatic trauma. The pattern of pooling can help identify those patients who may be at risk for becoming hemodynamically unstable. The authors are from Chang-Gung University, Kweishan, Taoyuan, Taiwan.

Patient selection: 276 patients with blunt hepatic trauma were reviewed, with 15 patients showing pooling of CT contrast material.

Rationale: Pooling of contrast material indicates free extravasation of blood usually as the result of active bleeding.

Pooling Within the Liver	Pooling Within the Peritoneal Cavity (Hemoperitoneum)	Type
absent	present	I
present	present	II
present	absent	III

where:

• No type was assigned for an absence of pooling in either location.

Type	Outcome
I	all of the patients (6 of 6) became hemodynamically unstable and required emergency laparotomy
II	4 of 6 patients became hemodynamically unstable and required laparotomy
III	all of the patients (3 of 3) remained hemodynamically stable

Intraparenchymal pooling with an intact hepatic capsule indicates self-limited hemorrhage which can usually be managed by non-operative management.

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Description

Specialty

ICD-10