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Hypovolemic shock complex: does the pancreatic perfusion increase or decrease at contrast-enhanced dynamic CT?

Hiroki Higashi1, Tsutomu Tamada, Akihiko Kanki

  • 1Department of Diagnostic Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.

Clinical Imaging
|October 22, 2013
PubMed
Summary

Severe trauma patients with hypovolemic shock show decreased pancreatic perfusion in early dynamic CT scans. This indicates reduced blood flow to the pancreas during shock, impacting organ function.

Keywords:
Computed tomographyContrast mediaHypovolemic shockPancreasPerfusion

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Area of Science:

  • Radiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Hypovolemic shock in severe trauma can affect organ perfusion.
  • Dynamic computed tomography (CT) is used to assess organ enhancement.
  • Pancreatic perfusion changes in shock are not fully understood.

Purpose of the Study:

  • To evaluate pancreatic contrast enhancement at dynamic CT.
  • To determine if pancreatic perfusion increases or decreases in severe trauma patients with hypovolemic shock.

Main Methods:

  • Included 90 blunt trauma patients (30 with, 60 without hypovolemic shock).
  • Performed dynamic CT scans of the abdomen.
  • Measured CT attenuation values of the pancreas in early and late phases.

Main Results:

  • Early phase pancreatic CT attenuation was significantly lower in hypovolemic shock patients (95.4 HU vs. 136.6 HU).
  • Late phase pancreatic CT attenuation was significantly higher in hypovolemic shock patients (95.9 HU vs. 87.2 HU).
  • Findings indicate decreased pancreatic perfusion and delayed enhancement in hypovolemic shock.

Conclusions:

  • Decreased early-phase pancreatic perfusion is a common finding in hypovolemic shock.
  • Delayed late-phase pancreatic enhancement is also characteristic of hypovolemic shock.
  • Dynamic CT effectively visualizes pancreatic perfusion changes in trauma patients with shock.