CT Cach Doc Phim o Bung
Transcript of CT Cach Doc Phim o Bung
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CÁCH ĐỌC CÁCH ĐỌC CHỤP CLVT CHỤP CLVT
BỤNGBỤNGBùi Văn GiangBùi Văn Giang
Saint Paul, 8-2008Saint Paul, 8-2008
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Một số khái niệmMột số khái niệm
Cửa sổCửa sổ Đơn vị tỷ trọngĐơn vị tỷ trọng Giải phẫuGiải phẫu Một số dấu hiệu cơ bảnMột số dấu hiệu cơ bản
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Một số khái niệmMột số khái niệm Cửa sổCửa sổ
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Một số khái niệmMột số khái niệm
Cửa sổCửa sổ Nhu mô: tổn thương tạng: u, Nhu mô: tổn thương tạng: u,
vỡ, nang, chảy máuvỡ, nang, chảy máu Mỡ: thâm nhiễm mỡ (viêm), khí Mỡ: thâm nhiễm mỡ (viêm), khí
(thủng tạng rỗng).(thủng tạng rỗng).
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Một số khái niệmMột số khái niệm Đơn vị tỷ trọngĐơn vị tỷ trọng
Khí: -1000HUKhí: -1000HU HH22O: 0 HUO: 0 HU Mỡ: <0 HUMỡ: <0 HU Dịch 20HUDịch 20HU Nhu mô: 30-40Nhu mô: 30-40 Máu 70-80HUMáu 70-80HU Xương >100 HUXương >100 HU
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Một số khái niệmMột số khái niệm
Cửa sổ Đơn vị tỷ trọng Giải phẫu lớp cắtGiải phẫu lớp cắt Một số dấu hiệu cơ bảnMột số dấu hiệu cơ bản
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Một số khái niệmMột số khái niệm
Cửa sổ Đơn vị tỷ trọng Giải phẫu Một số dấu hiệu cơ bảnMột số dấu hiệu cơ bản
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Pancréatite aiguë + thrombose splénique
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Viêm tụy cấp + giả phình
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Chấn thương thận kínChấn thương thận kínĐộ 1Độ 1
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Chấn thương thận kínChấn thương thận kínĐộ 1Độ 1
• • Độ 1: 75-85 % chấn thương thận kínĐộ 1: 75-85 % chấn thương thận kín
• • Tổn thương nhỏ:Tổn thương nhỏ:
- Đụng giập nhỏ nhu mô, không lấn tới tủy - Đụng giập nhỏ nhu mô, không lấn tới tủy
thậnthận
- Tụ máu dưới bao- Tụ máu dưới bao
• • Điều trị bảo tồnĐiều trị bảo tồn
[5]:Kawashima RadioGraphics 2001
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Chấn thương thận kínChấn thương thận kínĐộ 1Độ 1
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Chấn thương thận kínChấn thương thận kínĐộ 1Độ 1
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Chấn thương thận kínChấn thương thận kínĐộ 2Độ 2
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• • Độ 2: 10%Độ 2: 10%
• • Tổn thương nhu mô nhiều:Tổn thương nhu mô nhiều:
- Rách nhu mô vào tới tủy thận.- Rách nhu mô vào tới tủy thận.
- Thiếu máu thùy thận.- Thiếu máu thùy thận.
[5]:Kawashima RadioGraphics 2001
Chấn thương thận kínChấn thương thận kínĐộ 2Độ 2
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Chấn thương thận kínChấn thương thận kínĐộ 2Độ 2
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Chấn thương thận kínChấn thương thận kínĐộ 2Độ 2
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• • Độ 3 : Tổn thương nhu mô nặngĐộ 3 : Tổn thương nhu mô nặng- 5% - 5%
- Rách nhu mô thận phức tạp vào tới - Rách nhu mô thận phức tạp vào tới
xoang thận kèm tổn thương mạch ngoại vi xoang thận kèm tổn thương mạch ngoại vi
gây tụ máu, đái máu, thiếu máu nhu môgây tụ máu, đái máu, thiếu máu nhu mô
- Độ 4 : Tổn thương sâu vào tới - Độ 4 : Tổn thương sâu vào tới
đường bài xuất, mạch máuđường bài xuất, mạch máu
[5]:Kawashima RadioGraphics 2001
Chấn thương thận kínChấn thương thận kínĐộ 3Độ 3
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Chấn thương thận kínChấn thương thận kínĐộ 3Độ 3
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Chấn thương thận kínChấn thương thận kínĐộ 3Độ 3
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Chấn thương thận kínChấn thương thận kínĐộ 4Độ 4
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DIVERTICULITE COECALEDIVERTICULITE COECALE
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Trauma to the Solid VisceraTrauma to the Solid Viscera
Trauma to the Solid VisceraTrauma to the Solid Viscera
• LiverLiver• SpleenSpleen• KidneyKidney• PancreasPancreas• AdrenalAdrenal
Other Traumatic InjuriesOther Traumatic Injuries
• DiaphragmDiaphragm• MesenteryMesentery• SpineSpine• AortaAorta• Abdominal WallAbdominal Wall
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Hepatic Injury ClassificationHepatic Injury ClassificationGradeGrade CriteriaCriteria
11 Capsular avulsionCapsular avulsion
Superficial laceration(s) < 1 cm. deepSuperficial laceration(s) < 1 cm. deep
Subcapsular hematoma < 1 cm. thickSubcapsular hematoma < 1 cm. thick
Periportal blood trackingPeriportal blood tracking
22 Lacerations(s) 1-3 cm. deepLacerations(s) 1-3 cm. deep
Central/subcapsular hematoma(s) 1-3 cm. thickCentral/subcapsular hematoma(s) 1-3 cm. thick
33 Laceration(s) > 3 cm. deepLaceration(s) > 3 cm. deep
Central/subcapsular hematoma(s) > 3 cm. thickCentral/subcapsular hematoma(s) > 3 cm. thick
44 Central/subcapsular hematoma(s) > 10 cm. thickCentral/subcapsular hematoma(s) > 10 cm. thick
55 Bilobar maceration or devascularizationBilobar maceration or devascularization
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hemangiomahemangioma
Globular peripheral Globular peripheral enhancementenhancement
Lesion fills inLesion fills in
from from peripheryperiphery
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Gunshot to liver with active bleedGunshot to liver with active bleed
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Liver InjuryLiver Injury
Grade 1 lacerationGrade 1 laceration Liver laceration thought Liver laceration thought to be fissureto be fissure
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Liver InjuryLiver Injury
Grade 2 liver lacerationGrade 2 liver laceration
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Liver InjuryLiver Injury
Grade 3 Grade 3 Subcapsular Subcapsular hematomahematoma
Grade 3 Grade 3 Intraparenchymal Intraparenchymal hematomahematoma
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Liver LacerationLiver Laceration
Grade 4 lacerationGrade 4 laceration Delayed biloma Delayed biloma formationformation
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Liver LacerationLiver Laceration
Laceration extends to inferior vena cavaLaceration extends to inferior vena cava
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Liver InjuryLiver Injury
Devascularized left Devascularized left lobelobe
Gallbladder hematomaGallbladder hematoma
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Splenic Injury ClassificationSplenic Injury Classification
GradeGrade CriteriaCriteria
11 Localized capsular disruptionLocalized capsular disruption
Small subcapsular hematomaSmall subcapsular hematoma
22 Small peripheral lacerationsSmall peripheral lacerations
Parenchymal hematoma < 3 cm.Parenchymal hematoma < 3 cm.
33 Fracture extending to hilumFracture extending to hilum
Parenchymal hematoma > 3 cm.Parenchymal hematoma > 3 cm.
44 Shattered spleenShattered spleen
Vascular disruptionVascular disruption
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Splenic InjurySplenic Injury
Congenital cleftCongenital cleft
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Splenic InjurySplenic Injury
Grade 1 injuryGrade 1 injury Grade 2 injuryGrade 2 injury
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Splenic InjurySplenic Injury
Grade 3 injuryGrade 3 injury Grade 4 injuryGrade 4 injury
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Splenic InjurySplenic Injury
Infarcted spleenInfarcted spleen
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Splenic InjurySplenic Injury
Sentinel clot Sentinel clot signsign
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Splenic InjurySplenic Injury
Active arterial Active arterial bleedbleed
Delayed hematomaDelayed hematoma
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Splenic InjurySplenic Injury
Active arterial extravasation from splenic Active arterial extravasation from splenic lacerationlaceration
Subcapsular and perisplenic hematomasSubcapsular and perisplenic hematomas
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Splenic injurySplenic injury
Angiographic Angiographic embolizationembolizationActive bleedActive bleed
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Pancreas injuryPancreas injury
Pancreatic laceration with pseudocyst Pancreatic laceration with pseudocyst
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Pancreas injuryPancreas injury
Pancreas tail Pancreas tail laceration with blood laceration with blood in left anterior in left anterior pararenal spacepararenal space
Pancreatic body Pancreatic body lacerationlaceration
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Pancreas InjuryPancreas Injury
Pancreatic neck Pancreatic neck laceration - blood laceration - blood between pancreas between pancreas and splenic veinand splenic vein
Pancreatic head Pancreatic head contusioncontusion
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Renal Injury ClassificationRenal Injury Classification
CategoryCategory CriteriaCriteriaMinorMinor Renal contusionRenal contusion(85%)(85%) Small Small corticomedullary corticomedullary lacerationlaceration
Intrarenal hematomaIntrarenal hematomaSegmental infarctionSegmental infarctionSmall subcapsular Small subcapsular
hematomahematoma
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Renal Injury ClassificationRenal Injury Classification
CategoryCategory CriteriaCriteriaMajorMajor Parenchymal lacerations that communicate Parenchymal lacerations that communicate
(10%) (10%) with the collecting systemwith the collecting system Large subcapsular hematomaLarge subcapsular hematoma Complete lacerationComplete laceration Renal fractureRenal fracture Renal vein injuriesRenal vein injuries
CategoryCategory CriteriaCriteriaCatastrophicCatastrophic Shattered kidney Shattered kidney(5%)(5%) Renal artery avulsion or occlusion Renal artery avulsion or occlusion
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Renal InjuryRenal Injury
Ruptured congenital Ruptured congenital UPJ obstructed UPJ obstructed kidneykidney
Ruptured calyceal Ruptured calyceal diverticulumdiverticulum
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Renal InjuryRenal Injury
Renal contusionRenal contusion Renal laceration with Renal laceration with perirenal hematomaperirenal hematoma
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Renal InjuryRenal Injury
Small lacerationSmall laceration Delayed scan-Delayed scan-extravasation of extravasation of contrastcontrast
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Renal InjuryRenal Injury
Extravasated Extravasated contrast on 10 min contrast on 10 min delay scandelay scan
Ureter intact-surgery Ureter intact-surgery not necessarynot necessary
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Renal InjuryRenal Injury
Bilateral renal extravasation of Bilateral renal extravasation of contrastcontrast
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Renal InjuryRenal Injury
Fractured Fractured kidneykidney
Devascularized Devascularized segment,large segment,large hematomahematoma
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Renal InjuryRenal Injury
UPJ lacerationUPJ laceration Renal artery Renal artery occlusionocclusion
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Renal InjuryRenal Injury
Arterial occlusion Arterial occlusion causing renal infarctioncausing renal infarction
Arterial OcclusionArterial Occlusion
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Renal injuryRenal injury
Renal artery Renal artery pseudoaneurysmpseudoaneurysm
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Renal injuryRenal injury
Renal artery pseudoaneurysm Renal artery pseudoaneurysm embolizedembolized
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Adrenal HematomaAdrenal Hematoma
Adrenal hematoma and grade II liver Adrenal hematoma and grade II liver lacerationlaceration
Patient struck on right sidePatient struck on right side
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Bladder TraumaBladder Trauma
CT Cystography in the Evaluation of CT Cystography in the Evaluation of Bladder TraumaBladder Trauma
Lis,L.E., Cohen,A.J.Lis,L.E., Cohen,A.J. J Comput Assist Tomogr J Comput Assist Tomogr
1990;14:386-3891990;14:386-389
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Bladder Bladder Rupture(intraperitoneal)Rupture(intraperitoneal)
CT cystogram-350 cc of contrast (4%) CT cystogram-350 cc of contrast (4%) infused through Foley catheter.infused through Foley catheter.
free contrast in peritoneal cavityfree contrast in peritoneal cavity
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Bladder Bladder Rupture(intraperitoneal)Rupture(intraperitoneal)
Free contrast around Free contrast around liverliver
Contrast in cul-de-sacContrast in cul-de-sac
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Bladder Bladder Rupture(extraperitoneal)Rupture(extraperitoneal)
Extravasated contrast Extravasated contrast prevesicle spaceprevesicle space
Contrast tracks Contrast tracks into scrotuminto scrotum
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Mimic of bladder ruptureMimic of bladder rupture
Paravesicle hematoma with active arterial Paravesicle hematoma with active arterial bleedbleed
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Chest Chest
Pericardial and pleural effusionPericardial and pleural effusion
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Chest TraumaChest Trauma
Severe Lung contusionSevere Lung contusion
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Chest TraumaChest Trauma
Lung contusionLung contusion Pneumothorax, Pneumothorax, lacerationslacerations
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Chest TraumaChest Trauma
Paravertebral Paravertebral hematomahematoma
T6 vertebral T6 vertebral body fracturebody fracture
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Chest traumaChest trauma
Traumatic rupture of inferior vena cava into pericardiumTraumatic rupture of inferior vena cava into pericardium
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DiaphragmDiaphragm
Huge diaphragmatic hernia-patient fell Huge diaphragmatic hernia-patient fell from ladderfrom ladder
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Diaphragmatic HerniaDiaphragmatic Hernia
Subtle traumatic Subtle traumatic diaphragmatic herniadiaphragmatic hernia
Two days later, Two days later, stomach up in stomach up in chestchest
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Diaphragmatic HerniaDiaphragmatic Hernia
Stomach in chestStomach in chest Stomach constricted passing through Stomach constricted passing through
diaphragmdiaphragm
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Abdominal WallAbdominal Wall
Actively bleeding rectus muscle hematomaActively bleeding rectus muscle hematoma
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Soft tissue injurySoft tissue injury
Back hematomaBack hematoma
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SpineSpine
COMBINATION COMBINATION INJURIESINJURIES
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Spine TraumaSpine Trauma
Originally missed burst fractureOriginally missed burst fracture
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Spine TraumaSpine Trauma
Posterior element Posterior element spinous fracturespinous fracture
patient with patient with Ankylosing Ankylosing SpondylitisSpondylitis
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Combination InjuriesCombination Injuries
Devascularized left Devascularized left lobe of liverlobe of liver Pancreatic laceration Pancreatic laceration
and left renal infarctand left renal infarct
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Combination InjuriesCombination Injuries
Wide mediastinumWide mediastinum Periaortic hematoma-Periaortic hematoma-sign of aortic injurysign of aortic injury
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Combination InjuriesCombination Injuries
Aortic tearAortic tear Jejunal perforationJejunal perforation
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Combination InjuriesCombination Injuries
Aortic tearAortic tear Pancreatic lacerationPancreatic laceration
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Combination InjuriesCombination Injuries
Aortic tearAortic tear Bladder hematoma Bladder hematoma and ruptureand rupture
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Combination InjuriesCombination Injuries
Jejunal perforationJejunal perforation
Intraperitoneal bladder perforationIntraperitoneal bladder perforation
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Combination InjuriesCombination Injuries
Pattern of Impact determines Pattern of Impact determines combination injuriescombination injuries
Avoid Satisfaction of Search ErrorAvoid Satisfaction of Search Error
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Trauma to the Hollow Trauma to the Hollow VisceraViscera
DuodenumDuodenum JejunumJejunum IleumIleum ColonColon StomachStomach
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Bowel and Mesenteric Bowel and Mesenteric InjuriesInjuries
- 5% of patients after blunt abdominal trauma who 5% of patients after blunt abdominal trauma who undergo surgical explorationundergo surgical exploration
- Mortality of duodenal perforationMortality of duodenal perforation
= 65% if surgery delayed > 24 hours= 65% if surgery delayed > 24 hours
= 5% if surgery done in 1= 5% if surgery done in 1stst 24 hours 24 hours
CT FindingsCT Findings
Bowel Wall InjuriesBowel Wall Injuries
- thickening- thickening
- - intense wall enhancementintense wall enhancement
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CT FindingsCT FindingsPneumoperitoneumPneumoperitoneum-anterior peritoneal surface-anterior peritoneal surface-perihepatic/splenic areas-perihepatic/splenic areas-mesentery/omentum-mesentery/omentum-ligaments (falciform, etc)-ligaments (falciform, etc)
Free FluidFree Fluid-small bowel, low density & no air-small bowel, low density & no air-blood, intermediate density (high density if -blood, intermediate density (high density if
arterial)arterial)-oral contrast, very high density, > 150 HU-oral contrast, very high density, > 150 HU
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Duodenal TraumaDuodenal Trauma
Duodenal hematomaDuodenal hematoma
CT FindingsCT Findings
Duodenal InjuriesDuodenal Injuries
-descending/horizontal -descending/horizontal segmentssegments
-Retro/intraperitoneal-Retro/intraperitoneal
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Duodenal InjuryDuodenal Injury
Duodenal perforation-Duodenal perforation-missed originallymissed originally
Perforation seen on Perforation seen on UGI examUGI exam
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Duodenal PerforationDuodenal Perforation
Periduodenal Periduodenal hematomahematoma
One day later, One day later, duodenal duodenal perforationperforation
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Duodenal PerforationDuodenal Perforation
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Jejunal/Ileal InjuryJejunal/Ileal Injury
CT FindingsCT Findings fixation points fixation points ligament of Treitzligament of Treitz ileocecal valveileocecal valve
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Jejunal InjuryJejunal Injury
Triangles imply extraluminal fluidTriangles imply extraluminal fluid Jejunal perforationJejunal perforation
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Jejunal InjuryJejunal Injury
Mesenteric Mesenteric hematomahematoma
Jejunal Jejunal perforationperforation
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Jejunal InjuryJejunal Injury
Jejunal hematoma which perforatedJejunal hematoma which perforated
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Jejunal PerforationJejunal Perforation
Wall thickeningWall thickening Seat belt signSeat belt sign
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Jejunal PerforationJejunal Perforation
Bowel wall Bowel wall thickeningthickening
Blood in pelvisBlood in pelvis
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Jejunal PerforationJejunal Perforation
Extravasated oral Extravasated oral contrastcontrast
Burst fracture of Burst fracture of L2L2
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Free Intraperitoneal AirFree Intraperitoneal Air ““Little bubbles, big troubles”Little bubbles, big troubles” DistributionDistribution
- around liver- around liver
- in mesentery- in mesentery
- posterior to the rectus abdominis muscles- posterior to the rectus abdominis muscles
midrectus recessmidrectus recess
pararectus recessespararectus recesses
Delayed Scans May Be HelpfulDelayed Scans May Be Helpful
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Jejunal InjuryJejunal Injury
Occult jejunal Occult jejunal injuryinjury
Subtle bowel wall Subtle bowel wall thickeningthickening
Free fluid in pelvisFree fluid in pelvis
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Jejunal PerforationJejunal Perforation
Extraluminal air Extraluminal air at porta at porta hepatis, over hepatis, over liverliver
Same patient one day laterSame patient one day later
Extravasation of oral Extravasation of oral contrastcontrast
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Jejunal PerforationJejunal Perforation
Paracolic gutter fluid and mesenteric fluid Paracolic gutter fluid and mesenteric fluid may have different originsmay have different origins
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Jejunal PerforationJejunal Perforation
Extraluminal gas bubblesExtraluminal gas bubbles
LITTLE BUBBLESLITTLE BUBBLES BIG TROUBLESBIG TROUBLES
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Ileal, Cecal, Gastric TraumaIleal, Cecal, Gastric Trauma
Intense Bowel Wall EnhancementIntense Bowel Wall Enhancement
Low flow stateLow flow state Intravasation of contrastIntravasation of contrast
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Jejunal, Ileal InjuriesJejunal, Ileal Injuries
Bowel wall Bowel wall enhancement-enhancement-jejunal and ileal jejunal and ileal perforationsperforations
pneumoperitoneumpneumoperitoneum
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Ileal InjuryIleal Injury
Ileal wall Ileal wall enhancementenhancement
At operation, ileal perforationAt operation, ileal perforation
Bubble of Bubble of extraluminal air in extraluminal air in pararectus recesspararectus recess
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Ileal InjuryIleal Injury
Ileal injury – wall Ileal injury – wall thickeningthickening
Delayed perforationDelayed perforation
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Ileal PerforationIleal Perforation
Subtle Subtle pneumoperitoneumpneumoperitoneum
Ileal perforationIleal perforation
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Colonic InjuryColonic Injury
Pneumatosis of cecal wall-degloving injury of Pneumatosis of cecal wall-degloving injury of serosaserosa
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Colonic InjuryColonic Injury
Cecal Cecal perforationperforation
Traumatic herniaTraumatic hernia
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Colonic InjuryColonic Injury
Colonic infarctColonic infarct Traumatic herniaTraumatic hernia
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Colonic InjuryColonic Injury
Stab wound to colonStab wound to colon extravasated extravasated
contrastcontrast
Rectal Contrast used Rectal Contrast used alsoalso
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Stomach InjuryStomach Injury
Greater curvature hematoma and Greater curvature hematoma and perforationperforation
CT FindingsCT Findings
Stomach RuptureStomach Rupture
-children > adults-children > adults
-anterior wall > greater -anterior wall > greater curve > lesser curvecurve > lesser curve
-associated with splenic -associated with splenic traumatrauma
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Stomach RuptureStomach Rupture
Pneumoperitoneum-falciform ligament Pneumoperitoneum-falciform ligament seenseen
CT-pneumoperitoneumCT-pneumoperitoneum
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Stomach PerforationStomach Perforation
Extravasated oral contrast from stomachExtravasated oral contrast from stomach
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Mesenteric InjuriesMesenteric Injuries
CT FindingsCT Findings mesenteric fat streakingmesenteric fat streaking mass effect on bowelmass effect on bowel
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Mesenteric InjuryMesenteric Injury
Mesenteric hematomasMesenteric hematomas
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Mesenteric InjuryMesenteric Injury
Superior mesenteric vein bleedSuperior mesenteric vein bleed
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Mesenteric InjuryMesenteric Injury
Missed mesenteric Missed mesenteric bleed mimicking bleed mimicking bowel loopbowel loop
Delayed Delayed HematomaHematoma
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PneumoperitoneumPneumoperitoneum
Plain filmPlain film CT with lung windowsCT with lung windows
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PneumoretroperitoneumPneumoretroperitoneum
Plain filmPlain film CTCT
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Shock BowelShock Bowel
Small aorta and IVCSmall aorta and IVC Nonexcreting kidneysNonexcreting kidneys Diffuse bowel wall edemaDiffuse bowel wall edema
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Shock BowelShock Bowel
Diffuse bowel wall edemaDiffuse bowel wall edema
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OverhydrationOverhydration
Periportal edemaPeriportal edema
Bowel wall Bowel wall thickeningthickeningDistended IVC and Distended IVC and aortaaortaPeriportal edemaPeriportal edemaRetroperitoneal Retroperitoneal effusionseffusions
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OverhydrationOverhydration
Retroperitoneal Retroperitoneal effusioneffusion
Diffuse bowel wall Diffuse bowel wall edemaedema
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Shock BowelShock Bowel
Jejunal perforationJejunal perforation Shock bowelShock bowel
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CT signs suggestive of small CT signs suggestive of small bowel injurybowel injury
NO. (%)NO. (%)Small bowel wall thickeningSmall bowel wall thickening 18/19 18/19 (95)(95)Free Fluid or blood without Free Fluid or blood without associated solid visceral injuryassociated solid visceral injury 9/19 9/19 (47)(47)
Casey L, Vu D, Cohen AJ. Small Bowel Casey L, Vu D, Cohen AJ. Small Bowel Rupture after Blunt Trauma: CT signs and Rupture after Blunt Trauma: CT signs and Their SensitivityTheir Sensitivity
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CT signs pathognomic of bowel CT signs pathognomic of bowel rupturerupture
NO. (%)NO. (%)Extraluminal airExtraluminal air 7/19 7/19 (37)(37)Oral contrast extravasationOral contrast extravasation 8/19 8/19 (42)(42)Extraluminal air onlyExtraluminal air only 3/19 3/19 (16)(16)Oral contrast extravasation onlyOral contrast extravasation only 4/19 4/19 (21)(21)Both extraluminal air and Both extraluminal air and oral contrast extravasationoral contrast extravasation 4/19 4/19 (21)(21)
TOTALTOTAL 11/19 (58) 11/19 (58)
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Duodenal PerforationDuodenal Perforation
Duodenal perforation extravasates into the Duodenal perforation extravasates into the right anterior pararenal spaceright anterior pararenal space
Duodenal wall may be thickened by Duodenal wall may be thickened by edema or bloodedema or blood
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Jejunal and Ileal PerforationJejunal and Ileal Perforation
Jejunal and ileal perforation manifests as bowel Jejunal and ileal perforation manifests as bowel wall thickeningwall thickening
Extraluminal air and fluid may be subtleExtraluminal air and fluid may be subtle Lung windows help to disclose extraluminal airLung windows help to disclose extraluminal air
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Extraluminal FluidExtraluminal Fluid
Triangles imply extraluminal fluidTriangles imply extraluminal fluid Paracolic gutter fluid and mesenteric fluid Paracolic gutter fluid and mesenteric fluid
may have different originsmay have different origins
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Small Bowel InjurySmall Bowel Injury
Do not hesitate to repeat scan if the clinical Do not hesitate to repeat scan if the clinical condition deterioratescondition deteriorates
Shock and overhydration can cause Shock and overhydration can cause abnormal appearing small bowelabnormal appearing small bowel