Emergency radiology
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Emergency radiology · Dec 2013
Comparative StudyRadiation exposure before and after the introductionof a dedicated total-body CT protocolin multitrauma patients.
Total-body CT (TBCT) scanning in trauma patients is being increasingly used in trauma assessment. One of the major disadvantages of CT scanning is the amount of radiation exposure involved. The aim of this study was to assess the number of radiological investigations and their associated radiation exposure in multitrauma patients before and after the introduction of a total-body CT protocol as a primary diagnostic tool. ⋯ The overall effective dose during the total hospital admission was not significantly different between 2008 and 2010 (20 vs. 24 mSv, P = 0.509). In conlusion, after the introduction of a dedicated TBCT protocol, the TBCT rate was more than doubled. Although this increased the CT-induced trauma room radiation dose, the overall radiation dose throughout hospital admission was comparable between patients in 2008 and 2010.
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Emergency radiology · Dec 2013
ReviewEvaluating blunt pancreatic trauma at whole body CT: current practices and future directions.
Blunt pancreatic trauma almost always occurs in the setting of multiple severe injuries, and is usually diagnosed within the context of whole-body trauma CT. Associated injuries may flag the pancreas for greater scrutiny. ⋯ Characterization is improved with advanced post-processing techniques. We present useful diagnostic pearls, describe key pitfalls, and review advancements in the evaluation of pancreatic trauma at whole-body MDCT.
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Emergency radiology · Dec 2013
Review Case ReportsTension pneumocephalus: a case report with review of literature.
Tension Pneumocephalus (PC) was described 50 years ago. A case of pneumocephalus (PC) following cervical epidural injection in a 50-year-old male worsened by air travel and manifested as tension pneumocephalus, confirmed by advanced neuroimaging, is reported for the first time along with literature review. ⋯ Presenting features and clinical course along with Mount Fuji sign, Peaking sign, and air bubble sign observed in this case are described. Also, the importance of considering neurosurgical and spinal procedures leading to PC have to be considered by practitioners before issuing fitness certificate before air travel, as PC is likely to get transformed to tension PC and can cause an in-flight emergency.
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Emergency radiology · Dec 2013
Radiation exposure among patients with the highest CT scan utilization in the emergency department.
The risk of cancer from computed tomography (CT) scan radiation is a rising concern in the medical field. Our objectives were to determine how many patients received more than ten CT scans in an academic emergency department (ED) over the course of 7 years and to quantify their radiation exposure and lifetime attributable risk of cancer. An electronic chart review was performed at our urban academic institution with an annual census of 110,000 patients. ⋯ Among those undergoing CT imaging in our ED, high-exposure patients (greater than ten scans) constituted a significant minority, while more than one in four patients underwent more than one CT scan during the study period. While the presumed overall risk of radiation-induced cancer continues to be low, it is important for the emergency physician to use clinical knowledge as well as concern for the patient when utilizing radiographic imaging. Increasing attributable cancer risk may have important public health implications in the future, regardless of the low individual risk.