الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Abdominal trauma is a leading cause of morbidity and mortality in all age groups worldwide. It is considered number one cause of childhood death and disability, particularly in low and middle income counteries.
The use of the multi detector CT with its reconstructed images has showed great ability in the diagnosis of abdominal trauma.
The aim of this work was to study the current role of the MDCT in the assessment of blunt abdominal trauma in pediatric patients.
The current study included 30 pediatric patients referred to the Radiodiagnosis department at Alexandria University Hospital presenting with abdominal trauma, Full history taking, plain chest X-ray, ultrasound as well as MDCT were performed for all admitted stable paediatric patients.
Awareness of the practice of ALARA (‘as low as reasonably achievable’) and the iterative reconstruction techniques were attained to reduce the radiation exposure to children, in addition, paediatric parameters were considered and IV non-ionic contrast medium namely (Iopromide 300) was used.
Males were more vulnerable to trauma than females with ratio of 2:1. Children between 5 to 15 years old were more susceptible to blunt abdominal trauma. The most common mode of trauma was RTAs (road traffic accidents).
This study showed that MDCT with its adequate multi-planar capability and excellent spatial and temporal resolution is more sensitive than ultrasonography and plain radiography in the evaluation of blunt abdominal trauma in children.
Tri-phasic CT was able to diagnose different grades of splenic injuries and the associated complications, which allowed a wider use for the conservative and interventional radiology management. Operative management for spleen injury were held only in six patients, representing (26.1%)
Tri-phasic CT was of great benefit in the assessment of different grades of hepatic injury as well as its associated vascular and non-vascular complications. Which allowed to predict the success of the NOM protocol. Operative management was undertaken in only 4 patients representing only 10%.
Tri-phasic CT played important role in assessment of renal injuries, and its associated complications, using the arterial phases to asses vascular injuries and delayed phases to diagnose pelviureteric injuries, which allowed to choose NOM in most in the renal trauma patients. Only three patients were managed operatively representing 23%.
MDCT showed predictive imaging findings in the diagnosis of bowel injury; where the presence of fluid between bowel loops is the most accurate finding followed by bowel wall hyper dense hematoma and pneumopertioneum.
Tri-Phasic MDCT was able to differentiate between three types of urinary bladder injury, which had a great directing value in choosing the appropriate management.
Tri-Phasic MDCT grades of pancreatic injury was of great value to diagnose cases with pancreatic injury and its early and late associated complications.
Tri-Phasic MDCT diagnosed ureteric injuries. where spillage of contrast medium from ureteric tear in the excretory phase was a sure indicator for tear.
MDCT could diagnose Diaphragmatic injury, with herniated abdominal organs to the chest which is considered an emergency situation.
MDCT diagnosed accurately suprarenal gland injuries.