Radiologic diagnosis in abdominal trauma.

In a survey of its use in 198 cases of penetrating and nonpenetrating abdominal trauma causing various kinds of lesions, roentgenographic examination was found to be a considerable diagnostic aid. Consultation with a radiologist before, during and after the examination would seem indicated. The general plan of examination included anteroposterior projections with the patient erect, recumbent and in the left lateral decubitus positions, plus a posteroanterior film of the chest with the patient erect. Techniques varied with the condition of the patient and the nature of the lesion clinically suspected. Special procedures were done as dictated by the clinical and radiologic findings. Studies designed to demonstrate displacement of gastrointestinal and urinary organs should be made in anteroposterior and lateral projections. Factors that were important in determining the site of internal lesions from radiographic evidence were the site of associated fractures, reactive ileus, the position of foreign bodies, and by far the most important the roentgen abnormalities caused by escaped gas, blood, other fluids or contrast media, which caused abnormal densities, displacements of organs and blurring or obliteration of outlines normally visible.