Poster in European Congress of Emergency Medicine 2006

1. THE VALUE OF COMPUTER TOMOGRAPHY IN
INTRA-ABDOMINAL HEMORRHAGE-THE
SURGEON’S VIEW
Ir. Christodoulou, Z.Koukouritaki,Chr.Pogonidis,
E.Xenodoxidou, M. Handolias, A.Amanatidou,
C.Christianopoulos.
2ND SURGICAL DEPARTMENT, PAPANIKOLAOU
HOSPITAL,THESSALONIKI
PURPOSE: We outline the diagnostic strategies
applied for probable intra-abdominal hemorrhage in
clinical practice.
MATERIALS AND METHODS: We present 5 cases
admitted in Hospital with probable intra-abdominal
hemorrhage 1) An unstable hemodynamically 37-year-
old man, trauma victim 2)A 32-year old pregnant
woman with pathologic blood tests (Ht =17%) and
abdominal pain 3) A 92-year old lady suffering from rib
fractures after a fall 4) a 20-year-old woman with acute
abdominal pain and splenomegaly 5) A 50 year –old
woman in pain with history of intra-abdominal
hemorrhage twice, due to oral anticoagulant drugs.
RESULTS: Case 4 and 5 underwent an abdominal CT
examination: the 20-year old woman had a giant
hemorrhagic cyst of the spleen and an urgent
splenectomy was needed and case 5 had normal
findings. In the rest of cases, we did not use any
advanced imaging examination: in case 1, peritoneal
lavage was positive for blood and the patient
underwent an urgent laparotomy for major liver
trauma, in case 2 a chronic iron deficiency was
diagnosed and ECHO confirmed the diagnosis, and in
case 3, the clinical findings, the blood tests and ECHO
examination were enough to secure the absence of
intra-abdominal hemorrhage.
CONCLUSION: Algorithms are in practice applied in
custom clinical scenarios. Non typical clinical findings
and history of severe complications are dictating the
examination with a CT.