Which imaging modality is preferred for evaluating suspected intra-abdominal injury in a hemodynamically stable patient after resuscitation?

Which imaging modality is preferred for evaluating suspected intra-abdominal injury in a hemodynamically stable patient after resuscitation?

• A. Ultrasound FAST
• B. CT scan of the abdomen and pelvis
• C. MRI abdomen
• D. Plain X-ray abdomen

Answer: (B)

In a hemodynamically stable patient who has been resuscitated, CT scan of the abdomen and pelvis with IV contrast is the preferred imaging study because it provides a rapid, comprehensive assessment of intra-abdominal injuries. It detects solid organ injuries (liver, spleen, kidneys), hollow viscus or mesenteric injuries, and signs of active bleeding, guiding decisions between operative and nonoperative management. Ultrasound FAST, while useful at the bedside and especially in unstable patients, lacks sensitivity for many abdominal injuries and is operator-dependent; MRI offers excellent detail but is time-consuming and impractical in acute trauma. Plain X-ray has limited value for evaluating intra-abdominal injuries.

In a hemodynamically stable patient who has been resuscitated, CT scan of the abdomen and pelvis with IV contrast is the preferred imaging study because it provides a rapid, comprehensive assessment of intra-abdominal injuries. It detects solid organ injuries (liver, spleen, kidneys), hollow viscus or mesenteric injuries, and signs of active bleeding, guiding decisions between operative and nonoperative management. Ultrasound FAST, while useful at the bedside and especially in unstable patients, lacks sensitivity for many abdominal injuries and is operator-dependent; MRI offers excellent detail but is time-consuming and impractical in acute trauma. Plain X-ray has limited value for evaluating intra-abdominal injuries.