Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Case 69 Physiologic pelvic intraperitoneal fluid
- Case 70 Avoiding missed injuries to the bowel and mesentery: the importance of intraperitoneal fluid
- Obstetrics and gynecology
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 69 - Physiologic pelvic intraperitoneal fluid
from Section 6 - Pelvis
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Case 69 Physiologic pelvic intraperitoneal fluid
- Case 70 Avoiding missed injuries to the bowel and mesentery: the importance of intraperitoneal fluid
- Obstetrics and gynecology
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
Given the frequency that CT of the abdomen and pelvis is performed to evaluate the trauma patient, intraperitoneal “free” fluid is encountered quite often. Although a small quantity of isolated free intraperitoneal fluid is usually attributed to physiologic fluid in women of reproductive age, it is also seen in males.
Whilst in the past it was believed that free fluid identified on CT was an indicator of occult bowel, mesenteric, or solid organ injury, and it mandated laparotomy [1], it is now generally accepted that conservative management with a non-operative approach for hemodynamically stable patients who have a small quantity of free pelvic fluid is safe (Figure 69.1). These patients should have no clinical or imaging signs of bowel injury [2, 3]. The change in approach to small quantities of free pelvic fluid is likely related to the evolution of CT itself. Decreasing reconstruction slice thickness, and the introduction of routine multiplanar reformations likely increases the sensitivity of CT for the detection of small quantities of free intraperitoneal fluid [4].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 230 - 231Publisher: Cambridge University PressPrint publication year: 2013