Abstract

Background
The purpose of our study was to determine the clinical significance of isolated intraperitoneal fluid on abdominal CT in blunt trauma patients. Materials and Methods : We retrospectively reviewed the CT scans of 27 patients with blunt abdominal trauma who had scans showing normal findings except for the presence of intraperitoneal fluid. The collections of peritoneal fluid were characterized as small, moderate, or large. The location of the fluid was determined as Morison’s pouch, the perihepatic space, the perisplenic space, the paracolic gutter, the interloopal space, or the pelvic cavity. The amount and the location of fluid were compared between patients who required surgical treatment and those who were managed conservatively. Results : In most patients, the amount of intraperitoneal fluid was small and moderate (66%) as opposed to large (33%). Intraperitoneal fluid tended to accumulate in Morison’s pouch (66%). Eighteen patients had fluid in two or fewer locations, and 9 patients had fluid in three or more locations. Laparotomies were required in two patients (11%) are with a small amount of fluid and one with a moderate amount compared with 4 patients (44%) with large amounts. Mesenteric and small bowel injuries were noted in all six patients at laparotomy. Of the 8 patients with fluid in the interloopal space, 5 (62%) required a laparotomy, which revealed small bowel and mesenteric injuries. Conclusion: Patients with blunt abdominal trauma who have small and moderate amounts of isolated intraperitoneal fluid shown by CT may generally be treated conservatively. However, even a small quantity of intraperitoneal fluid in the interloop location, it should raise suspicion of bowel or mesenteric injury.

• Keywords: Abdomen, CT, Intraperitoneal fluid