In their retrospective study, Nummela et al [29] found that arterial and venous phases of the chest, abdomen, and pelvis CT facilitated recognition of active bleeding in patients with penetrating thoracic trauma. Differentiating between arterial and venous hemorrhage may have treatment implications. For example, a hemodynamically stable patient with active arterial bleeding may be treated with an angioembolization procedure, whereas bleeding from a venous structure may result in supportive care [29,33]. MRI Chest, Abdomen, and Pelvis Without And With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma. Penetrating Torso Trauma MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, foreign bodies and/or ballistic fragments, and mediastinal injuries, which should be treated immediately. Radiographic evaluation can also help identify retained foreign bodies and suggest trajectory which may direct initial surgical exploration. CT Abdomen and Pelvis With IV Contrast CT could be performed if there is suspected suspicion for intraperitoneal violation. Overall, liberal use of imaging in ballistic trauma is recommend because the trajectory can be unpredictable. Diaphragmatic excursion may be high at time of injury, making intra-abdominal injuries difficult to exclude. CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of adding a noncontrast phase to a contrast-enhanced CT abdomen and pelvis for initial evaluation of penetrating torso trauma limited to the chest.
Penetrating Torso Trauma. In their retrospective study, Nummela et al [29] found that arterial and venous phases of the chest, abdomen, and pelvis CT facilitated recognition of active bleeding in patients with penetrating thoracic trauma. Differentiating between arterial and venous hemorrhage may have treatment implications. For example, a hemodynamically stable patient with active arterial bleeding may be treated with an angioembolization procedure, whereas bleeding from a venous structure may result in supportive care [29,33]. MRI Chest, Abdomen, and Pelvis Without And With IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without and with IV contrast for initial evaluation of patients with penetrating torso trauma. Penetrating Torso Trauma MRI Chest, Abdomen, and Pelvis Without IV Contrast There is no relevant literature regarding the use of MRI chest, abdomen, and pelvis without IV contrast for initial evaluation of patients with penetrating torso trauma with hypotension. Radiography Trauma Series Chest radiographs can recognize contusions, pneumothorax, hemothorax, rib fractures, foreign bodies and/or ballistic fragments, and mediastinal injuries, which should be treated immediately. Radiographic evaluation can also help identify retained foreign bodies and suggest trajectory which may direct initial surgical exploration. CT Abdomen and Pelvis With IV Contrast CT could be performed if there is suspected suspicion for intraperitoneal violation. Overall, liberal use of imaging in ballistic trauma is recommend because the trajectory can be unpredictable. Diaphragmatic excursion may be high at time of injury, making intra-abdominal injuries difficult to exclude. CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature regarding the use of adding a noncontrast phase to a contrast-enhanced CT abdomen and pelvis for initial evaluation of penetrating torso trauma limited to the chest.