JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
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Pelvic injuries are an important issue in trauma patients, largely as a result of the major disruptive forces required to fracture the pelvic ring. Despite the growing influence of more sophisticated techniques such as CT and MR in the evaluation of pelvic trauma, conventional imaging remains important, especially in the initial detection of fractures. Several plain film incidences can be used to detect and evaluate a fracture, so that the exact diagnosis can be made in the emergency room. ⋯ Cystography can be used to detect bladder ruptures. Angiography can detect the bleeding site, and therapeutic embolization can stop bleeding. MR imaging is becoming more important, as it can detect occult fractures, especially in the elderly patient.
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A direct frontal upper abdominal impact and a bicycle fall in a child are classical mechanisms of blunt pancreatic injury. Clinical symptoms are not characteristic. Serum amylase level is frequently normal at admission and peritoneal lavage fluid amylase is not diagnostic. ⋯ Both modalities are unable to detect pancreatic duct rupture. As ERP cannot be performed in all trauma patients, only patients with minor pancreatic injury can be enrolled in a conservative management without surgical revision. The role of multislice CT at admission and MRP has to be investigated to increase diagnostic efficiency in pancreatic duct injury.