Significance of periportal low-attenuation zones following blunt trauma in children

The CT scans of 400 consecutive children evaluated with CT following blunt abdominal trauma were evaluated to determine the frequency of periportal low-attenuation zones, assess patterns of associated intraabdominal injury, and examine clinical outcome. Periportal low-attenuation zones were noted in...

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Bibliographic Details
Published in:Pediatric radiology 1993-09, Vol.23 (5), p.388-390
Main Authors: SIVIT, C. J, TAYLOR, G. A, EICHELBERGER, M. R, BULAS, D. I, GOTSCHALL, C. S, KUSHNER, D. C
Format: Article
Language:English
Subjects:
Abdominal Injuries - diagnostic imaging
Adolescent
Adrenal Glands - injuries
Biological and medical sciences
Child
Child, Preschool
Digestive system
Female
Humans
Infant
Investigative techniques, diagnostic techniques (general aspects)
Liver - injuries
Male
Medical sciences
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Tomography, X-Ray Computed
Wounds, Nonpenetrating - diagnostic imaging
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Summary:The CT scans of 400 consecutive children evaluated with CT following blunt abdominal trauma were evaluated to determine the frequency of periportal low-attenuation zones, assess patterns of associated intraabdominal injury, and examine clinical outcome. Periportal low-attenuation zones were noted in 60 children (15%). The presence of these zones was associated with a significantly higher incidence of intraabdominal injury (60% versus 11%, p = 0.0001). Injuries most frequently associated with zones of periportal low-attenuation included hepatic (n = 23, 38%), and adrenal (n = 14, 23%). Children who had periportal low-attenuation zones tended to be more physiologically unstable as evidenced by a lower Trauma Score (diffuse, 11.9; focal, 13.4) than children without the zones (15.1, p = 0.0001). The presence of these zones was also associated with a significantly higher mortality rate (13% versus 1%, p = 0.0001). Ten children who had periportal low-attenuation zones and no hepatic injury on CT had a normal appearing liver on gross inspection at surgery or autopsy. In conclusion, periportal low-attenuation zones are common in children who have hepatic injury. These zones may be seen in conjunction with non-hepatic visceral injury or in the absence of intraabdominal injury. The presence of zones of periportal low-attenuation is associated with a higher index of physiologic instability, and higher mortality.
ISSN:0301-0449
1432-1998
DOI:10.1007/BF02011968