TRAUMA ABDOMENDr.JB.Prasodjo,dr.Sp.Rad. (K)April 2011

Gambaran makro

VERTEBRAE NORMALFOTO:-AP-LATERAL-OBLIQUE ( BILA PERLU )YANG DIPERHATIKAN :DiscusForamenPedicleCorpus VertebraeSoft tissue

Perkembangan lengkung vertebra

Diagram foto lumbal lateral

Diagram foto Lumbosacral (LS) lateral

Diagram foto LS oblik

LS joint

Stabilitas LS joint

Analisis LS joint lishtesis

FleksiB. Ekstensi

FOTO : 2 POSISI SATU DGN LAIN

PD FRAKTUR PERHATIKAN :-UMUR-LOKASI FRAKTUR-POSISI FRAGMENUTK LOKASI TL DIBAGI :-1/3 PROX-1/3 MED-1/3 DIS

FRAKTUR TL. PUNGGUNGLOKASI :-TORAKAL BAG. BAWAH + LUMBALFOTO: AP + LATRAD:-VERT. BENTUK BAJI / KAPAK-DISK MASIH BAIK

Fraktur vertebra lumbal

CT Lumbal 2Structure "A" Structure "B" Structure "C" Structure "D"

CT Lumbal 3Structure "A" Structure "B" Structure "C" Structure "D"

Laserasi HeparA. Liver B. Fluid in the peritoneal cavity C. Left kidney (salah)D. Falciform ligament E. Splenic flexure

Laserasi HeparThe items seen on the CT at liver are the liver laceration with hematoma (#1), gallbladder (#2), nasogastric tube (#3), inferior vena cava (#4), aorta (#5), tail of the pancreas (#6), and spleen (#7).

Diagnosis: Liver laceration, severe The most frequent site of liver injury is the posterior segment of the right lobe because of its large volume and its proximity to ribs and vertebrae. The dual blood supply of the liver and the inability of liver veins to contract means that hemorrhage from a liver injury may be very significant. However, if the liver capsule remains intact, the injuries are less serious. Fortunately the liver heals rapidly and delayed rupture rarely occurs.

Laserasi LienA. Spleen B. Splenic laceration C. Gallstones D. Liver E. Pancreas

Diagnosis: Splenic laceration In a patient with major trauma, three examinations are indicated. 1. Lateral C-spine to rule out cervical spine injuries. 2. Chest x-ray to rule out injury to the heart, great vessels, lungs, and mediastinum and to assess integrity of the diaphragm. 3. Contrast-enhanced CT of the abdomen (if the patient is hemodynamically stable) to diagnose and evaluate injury to the spleen, liver, kidneys, pancreas, retroperitoneum, and pelvis.

Laserasi GinjalA. Inferior vena cava B. Right kidney C. Left kidney D. Head of pancreas E. Liver

A contrast-enhanced CT was obtained which demonstrates a large focal area of lack of perfusion (arrowheads) in the left renal parenchyma. This represents renal laceration with hematoma. There is also a small perirenal hematoma. Other structures are: A=aorta B=right kidney C=left kidney D=head of pancreas E=liver Diagnosis: Renal laceration with hematoma

Laserasi Ginjal1=liver 2=gallbladder 3=stomach 4=bowel 5=liver laceration 6=right kidney 7=left kidney 8=aorta

Laserasi Ginjal1=bowel 2=inferior vena cava 3=aorta 4=retroperitoneal hemorrhage 5=acute bleeding into left kidney 6=inferior tip of right kidney

Laserasi Ginjal1=bowel 2=right ureter 3=right psoas 4=retroperitoneal hemorrhage 5=right sacral fracture 6=diasthesis left S-I joint

There is no perfusion of the left kidney on CT1 and CT2. This is best explained by a tear of the left renal artery causing lack of perfusion of the left kidney. On CT2 the high attenuation represents acute bleeding. A hematoma in the retroperitenum is seen on CT2 and CT3. Diagnosis: Avulsion of renal artery At surgery, a tear of the left renal artery was found with a large retroperitoneal hematoma. The patient required a left nephrectomy.

Ruptura VUA. Air in the urinary bladder B. Left ureter (salah)C. Contrast in the urinary bladder D. Contrast outside of the urinarybladder E. Contrast in the peritoneal cavity

Ruptura VU

Two CT images are shown (CT above acetabulum and CT at sacrum). A=air in urinary bladder B=right ureter C=contrast in urinary bladder D=contrast outside urinary bladder E=contrast in peritoneal cavity This patient had an intraperitoneal bladder rupture and underwent urgent surgical repair. Diagnosis: Bladder rupture

*Perhatikan for intervert dan apophyseal joint daerah lumbal.*Pertumbuhan lengkung vertebra sejak lahir mengangkat leher berdiri dan berjalan pekerjaan sehari-hari dst.*Gambaran telinga for intervert*Perhatikan gambaran scotty dog pada foto oblik Lumbal bawah.