Lubner M, Demertzis J, Lee JY, Appleton CM, Bhalla S, Menias CO. CT evaluation of shock viscera: a pictorial review.
Emerg Radiol 2007;
15:1-11. [PMID:
17960437 DOI:
10.1007/s10140-007-0676-z]
[Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 09/26/2007] [Indexed: 11/29/2022]
Abstract
The purpose of this article is to review both the pathophysiology and the computed tomography features of the hypoperfusion complex and shock viscera. The main findings include dilated fluid-filled loops of bowel with hyperenhancing mucosa, intensely enhancing kidneys and mesenteric vasculature, and small caliber, dense aorta and collapsed, slit-like inferior vena cava. Variable features include increased enhancement of the adrenals, decreased enhancement of the spleen, and altered enhancement of the pancreas with both hypo- and hyperenhancement described. This complex of findings indicates a tenuous hemodynamic status and has been associated with a poor prognosis. In addition, it is important to discern this collection of findings from direct injury to the viscera to aid in appropriate triage and management of the patients' injuries.
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