Changes in Approach to Solid Organ Injury: What the Radiologist Needs to Know

Area of Science:

• Radiology
• Trauma Surgery
• Medical Imaging

Background:

• Interpreting computed tomography (CT) scans for solid organ trauma is complex.
• Management strategies for solid organ trauma are evolving.
• Accurate CT interpretation is crucial for patient outcomes.

Purpose of the Study:

• To review challenges in interpreting trauma CT images for solid organ injuries.
• To discuss updated American Association for the Surgery of Trauma (AAST) Organ Injury Scales (2018).
• To highlight imaging findings in nonoperative and damage control surgery patients.

Main Methods:

• Literature review focusing on trauma CT imaging protocols.
• Analysis of changes in AAST Organ Injury Scales for liver, spleen, and kidney.
• Review of imaging findings in patients undergoing nonoperative management or damage control surgery.

Main Results:

• CT imaging protocols have specific pearls and pitfalls for detecting traumatic solid organ injuries.
• The 2018 AAST Organ Injury Scales present key changes impacting management strategies.
• Distinct imaging findings are observed in patients managed nonoperatively versus post-damage control surgery.

Conclusions:

• Understanding updated AAST scales and specific imaging findings is essential for radiologists.
• Effective interpretation of trauma CT aids in optimizing management of solid organ injuries.
• This review provides a framework for navigating challenges in trauma CT interpretation.