technetium-tc-99m-sulfur-colloid and Wounds--Penetrating

To evaluate the use of biliary scintigraphy with 99m Tc-dimethyl analogs (HIDA) in traumatic liver injuries, a group of 26 patients with penetrating and blunt liver injuries were studied. The results indicate that HIDA scanning is an effective noninvasive method of evaluating the hepatobiliary tree in the post-traumatic setting. The HIDA scan is a sensitive tool for studying the hepatic parenchyma and the presence or absence of bile leaks. Its evaluation of the extrahepatic biliary ductal system is not specific and should be assessed with further studies. Gallbladder nonvisualization by HIDA scans in this setting cannot be presumed to be secondary to acute cholecystitis and should be interpreted with extreme caution.

Topics: Adult; Biliary Tract; Evaluation Studies as Topic; Humans; Imino Acids; Liver; Radionuclide Imaging; Retrospective Studies; Spleen; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid; Wounds, Nonpenetrating; Wounds, Penetrating

Biliary scintigraphy was used to examine 21 patients who had suspected non-iatrogenic biliary trauma. Seven patients (33%) had scintigraphic evidence of biliary leakage. Ultimately, surgical biliary repair was required for only three of these patients. Visualization of the gallbladder did not occur in eight trauma patients, but only one patient was shown to have cholecystitis. In this series, 16 patients had Tc-99m sulfur colloid scans that offered no significant advantage over cholescintigraphy in the detection of hepatic parenchymal defects. Biliary scintigraphy provides clinically useful information in cases both of blunt and penetrating trauma.

Topics: Adult; Bile Ducts; Female; Gallbladder; Gallium Radioisotopes; Humans; Liver; Male; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Wounds, Nonpenetrating; Wounds, Penetrating

A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury.

Topics: Abdominal Injuries; Accidents, Traffic; Adolescent; Child; Child, Preschool; Female; Humans; Male; Radionuclide Imaging; Spleen; Splenectomy; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Wounds, Penetrating