Periportal edema in trauma patients: correlation with trauma severity

Periportal edema (PPE) can be seen in different clinical settings, including in patients following trauma. However, the underlying mechanisms and clinical significance in trauma patients still remain unclear.

To determine the incidence of PPE in CT scans of trauma patients and to correlate PPE with trauma severity and different patterns of injury.

We retrospectively analyzed contrast-enhanced spiral CT scans of 127 trauma patients that were referred to our Trauma Center Level I between January 2006 and June 2007. According to the Injury Severity Score (ISS), 70 patients with an ISS < 16 (minor trauma) were assigned to group 1 and 57 patients with an ISS ≥16 (major trauma) to group 2.

The presence of PPE was significantly (p < 0.01) higher in group 2 (22 of 57 patients [38.6%]) than in group 1 (10 of 70 patients [14.3%]). In 29 patients PPE presented with a diffuse pattern and in three patients with a focal pattern, affecting only one liver lobe. In 14 patients PPE was found in absence of abdominal injuries. In addition, PPE was present in five patients with abdominal injuries but without liver injury.

PPE is seen significantly more often on abdominal CT scans following major traumas (ISS ≥ 16), but is not necessarily associated with liver injury.