Diagnostic Imaging in Pediatric Trauma

ISBN-13: 9781447131021 / Angielski / Miękka / 2012 / 202 str.

J. L. Gwinn; P. Stanley

Opis

Trauma to various organ systems is a common medical problem in the pediatric age group. With the increase in vehicular traffic and active participation in contact sports, as well as a change in the social atmosphere, the incidence of injury to children is increasing. There is considerable morbidity associated with these injuries and accidents are the most common cause of death in this population group. The radiologist, using the various diagnostic radiological moda lities available, becomes involved in practically all cases of trauma of any degree of seriousness. The radiological methods lend themselves not only to determining the specific diagnosis but also to assessing the extent of the injury. This is important in determining of the patient as in recent years a more conserva the management tive type of therapy is advocated in several types of injury. As has been said, "Children are not like adults," hence injuries are of different types from those seen in adults. The ligaments and tendons of children are stronger than the bone structure, thus sprains and strains are not as common as fractures. Certain organs are in a less protected position in a child and may readily be injured from relatively minor trauma. Injury due to violent action of others such as gunshot and stab wounds are not as common as in the adult population but they are increasing in the teenage group. Blunt trauma or that due to rapid deceleration is the usual type of trauma seen in childhood."

Spis treści

1 Introduction.- 2 Urinary Tract Trauma.- 2.1 Renal Trauma.- 2.1.1 Classification of Injury.- 2.1.1.1 Contusion of the Kidney.- 2.1.1.2 Parenchymal Injury Without Pyelocalyceal Involvement.- 2.1.1.3 Parenchymal Injury with Pyelocalyceal Involvement.- 2.1.1.4 Renal Pedicle Injury.- 2.1.2 Iatrogenic Trauma.- 2.1.3 Management and Complications.- 2.2 Ureteral Trauma.- 2.3 Bladder Trauma.- 2.4 Urethral Trauma.- References.- 3 Neuroradiology in Head Trauma.- 3.1 Introduction.- 3.1.1 General Comments.- 3.1.2 Skull X-rays.- 3.1.3 Angiography.- 3.1.4 Computerized Tomography.- 3.1.5 Echoencephalography.- 3.1.6 Air Studies.- 3.1.7 Radionuclide Brain Scanning.- 3.2 Trauma Involving the Pediatric Skull.- 3.2.1 Skull Fractures — General Comments.- 3.2.2 Fractures Involving the Skull Base, Paranasal Sinuses, and Petromastoid Structures.- 3.2.3 Depressed Skull Fractures.- 3.2.3.1 General Comments.- 3.2.3.2 In Infancy.- 3.2.4 Trauma to the Infant’s Skull.- 3.2.4.1 Molding.- 3.2.4.2 Cephalohematoma.- 3.2.5 Enlarging Skull Fractures.- 3.2.6 Roentgenographic Changes in Head Bangers.- 3.2.7 Intracranial Foreign Bodies.- 3.3 Intracranial Hemorrhage and Cerebral Trauma.- 3.3.1 Fundamental Considerations.- 3.3.2 Intracerebral Hematoma.- 3.3.3 Intraventricular Hemorrhage.- 3.3.4 Subarachnoid Hemorrhage.- 3.3.5 Subdural Hematoma.- 3.3.5.1 Timing and Density of Subdural Hematoma.- 3.3.5.2 Acute Subdural Hematoma.- 3.3.5.3 Isodense Subdural Hematoma.- 3.3.5.4 Chronic Subdural Hematoma.- 3.3.5.5 Skull Film in Subdural Hematoma.- 3.3.6 Extradural Hematoma.- 3.3.7 Cerebral Contusion.- 3.3.8 Cerebral Edema.- 3.3.9 Acute General Cerebral Swelling.- 3.4 Traumatic Vascular Lesions.- 3.4.1 Traumatic Aneurysms.- 3.4.2 Arteriovenous Fistulas.- 3.4.3 Dissecting Aneurysm.- 3.4.4 Posttraumatic Spasm.- 3.4.5 Increased Intracranial Pressure.- 3.4.6 Posttraumatic Arterial Stenosis and Occlusion.- 3.4.7 Strangling.- 3.4.8 Cerebral Infarction.- 3.4.9 Venous Sinus Occlusion.- 3.4.10 Subepicranial Varix.- 3.5 Conclusion: Neuroradiology in Head Trauma in Perspective.- References.- 4 Injuries to the Spine.- 4.1 Cervical Spine.- 4.1.1 Occipital-atlantoaxial Region.- 4.1.1.1 Pseudosubluxation of Axis.- 4.1.1.2 Atlanto-occipital Dislocation.- 4.1.1.3 Atlanto-occipital Instability.- 4.1.1.4 Jefferson Fracture (Vertical Compression Injury of C1).- 4.1.1.5 Extension Fracture of Atlas.- 4.1.1.6 Isolated Atlanto-axial Dislocation.- 4.1.1.7 Fractures of the Odontoid.- 4.1.1.8 Hangman’s Fracture.- 4.1.2 Injuries Below the Axis.- 4.1.2.1 Flexion Injuries.- 4.1.2.2 Hyperextension Injuries.- 4.1.2.3 Pathological Fractures.- 4.2 Thoracolumbar Spine.- 4.2.1 Flexion Injuries.- 4.2.2 Seat-belt Hyperflexion Injury.- 4.2.3 Compression.- 4.2.4 Rotation.- 4.2.5 Extension.- 4.2.6 Shearing.- 4.2.7 Transverse Process Fractures.- 4.2.8 Posttraumatic Deformity.- 4.3 Lumbosacral Spine.- 4.3.1 Fatigue or Stress Changes.- 4.3.2 Fractures of the Sacrum and Coccyx.- 4.3.3 Coccyx Injuries.- 4.3.4 Radiation Injury to the Lumbar Spine.- References.- 5 Facial and Temporal Bone Trauma.- 5.1 Facial Trauma.- 5.1.1 Roentgenographic Evaluation.- 5.1.2 Patterns of Facial Injury.- 5.1.2.1 Soft Tissues.- 5.1.2.2 Nasal Bones.- 5.1.2.3 Teeth.- 5.1.2.4 Mid Face.- 5.1.2.5 Orbital.- 5.1.2.6 Cribriform Plate.- 5.1.2.7 Temporomandibular Joint.- 5.1.2.8 Mandible.- 5.1.2.9 Complications.- 5.2 Temporal Bone Trauma.- 5.2.1 Neurosensory Hearing Loss.- 5.2.2 Conductive Hearing Loss.- 5.2.3 Facial Nerve Injury.- 5.2.4 Sequelae of Temporal Bone Trauma.- References.- 6 Nuclear Medicine and Ultrasound in Pediatric Trauma.- 6.1 Brain.- 6.2 Lungs.- 6.3 Abdomen.- 6.3.1 Liver.- 6.3.2 Spleen.- 6.3.3 Pancreas.- 6.4 Renal.- 6.5 Bone.- 6.6 Conclusion.- References.- 7 Pancreatic and Adrenal Trauma.- 7.1 Pancreatic Trauma.- 7.2 Adrenal Trauma.- References.- 8 Injuries to the Liver and Spleen.- 8.1 Hepatic Trauma.- 8.1.1 Plain Films.- 8.1.2 Intravenous Urogram.- 8.1.3 Isotopes and Ultrasound.- 8.1.4 Arteriography.- 8.1.5 Cholangiography.- 8.1.6 Computerized Tomography.- 8.1.7 Radiation-induced Injury.- 8.2 Injuries to the Spleen.- References.- 9 Gastrointestinal Trauma.- 9.1 Stomach.- 9.1.1 Clinical.- 9.1.2 Roentgenographic.- 9.2 Duodenum.- 9.2.1 Clinical.- 9.2.2 Roentgenographic.- 9.3 Small Intestine.- 9.3.1 Clinical.- 9.3.2 Roentgenographic.- 9.4 Colon.- 9.4.1 Clinical.- 9.4.2 Roentgenographic.- 9.5 Summary.- References.- 10 Chest Trauma.- 10.1 Soft Tissues.- 10.2 Fractures of the Rib Cage and Sternum.- 10.3 Pneumothorax.- 10.4 Hemothorax.- 10.5 Chylothorax.- 10.6 Tracheobronchial Injury.- 10.7 Lung Contusion, Hematoma Formation, and Lung Cysts.- 10.8 Postshock Lung.- 10.9 Foreign Body Aspiration.- 10.10 Toxic Inhalation Pneumonitis.- 10.11 Near Drowning.- 10.12 Cardiac Contusion.- 10.13 Aortic Laceration/Rupture.- 10.14 Esophagus.- 10.15 Diaphragmatic Injury.- 10.16 Trauma Related to Artificial Support Systems and Resuscitation.- 10.16.1 Endotracheal Intubation.- 10.16.2 Vascular Catheters.- 10.16.3 Esophageal Pseudodiverticula in the Newborn.- 10.16.4 Respirator-related Problems.- 10.17 Trauma Related to Therapy.- 10.17.1 Radiation- and Chemotherapy-induced Pneumonitis.- 10.17.2 Tracheostomy Complications.- References.- 11 Skeletal Trauma.- 11.1 Diagnosis.- 11.2 Types of Fracture.- Epiphyseal Fractures.- 11.3 Types of Trauma.- 11.3.1 Intrauterine Trauma.- 11.3.2 Birth Trauma.- 11.3.3 Pathologic Fractures.- 11.3.4 Stress Fractures.- 11.3.5 Athletic Injuries.- 11.3.6 Battered Child Syndrome.- 11.4 Conclusion.- References.