Radiology
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Three hundred patients who had sustained blunt abdominal injury were evaluated with computed tomography (CT). The images showed areas of hemorrhage by varying attenuation coefficients (average, 45 Hounsfield units; exceeding 30 Hounsfield units in all cases except in those patients with bleeding more than 48 hours old). Small hematomas tended to accumulate near the site of origin while free intraperitoneal bleeding most frequently accumulated in the Morison pouch, paracolic gutters, and pelvis. ⋯ Only one false-negative and two false-positive CT interpretations occurred, and each was potentially avoidable in retrospect. CT is sensitive and specific for the diagnosis of hemoperitoneum and can estimate the extent and probable source of bleeding. This information may obviate the need for a peritoneal lavage and laparotomy in many instances.
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Testicular salvage rates are improved markedly when surgical correction of a ruptured tunica albuginea is performed within 72 hours after a scrotal injury. The authors studied 11 patients who had suffered various types of blunt or penetrating trauma to the scrotum. The importance of ultrasound for the evaluation of the traumatized scrotum and detection of a testicular rupture is stressed. The spectrum of abnormalities that may be present after a scrotal injury is described.