| Radiology
Variants, Over-reads & Misreads
VOMIT Protection
Pancreatic Injury
Case 1
Tim Hardcastle
11.10.2004
I operated a patient today,
who on CT abdo had a VERY convincing pancreatic transection
(good quality scan), after appropriate mechanism of injury,
and guess what - NORMAL Pancreas. I suppose this is a
VOMIT or is it a BARF!?
Here are the CT cuts -
8 consecutive slices are produced here. Our standard protocol
for Trauma is 5mm slices! (Not ideal, but thats all we
can afford, in resource challenged RSA). You will note
that the liver has a subcapsular haematoma to the right
of the falciform, otherwise (N). The first pancreas view
looks intact, but the subsequent three cuts show a possible
injury to the neck, then the 3rd part of duodenum comes
thru and looks normal.
I don't think we can ignore
a suggestive CT of the pancreas, and after all a negative
laparotomy is still better than a positive post-mortem.
The Panel's Read:
Other Views:
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THE ANTIEMETIC PANEL
Sal Sclafani
Trauma radiologist
New York
Bertil Leidner
Trauma Radiologist
Karolinska, Stockholm
Ken Mattox
Trauma & Thoracic Surgeon
Houston
WHAT IS VOMIT?
VOMIT is 'Victim of Medical
Imaging Technology'. A term used collectively to describe
misuse or misreading of imaging studies. Often associated
with VOMIT is BARF: Brainless Application of Radiologic
Findings.
The term is clearly biased
and overused, yet has a sound principle - that inappropriate
radiology may be worse than no radiology at all.
These pages will present
these cases (usually discussed by the Trauma-list, and
have the films reviewed by a select panel, as well as
reads by other physicians).
If you have a case that
you think classifies as a potential VOMIT, please email
a brief outline and the images to 'antiemetic@trauma.org'.
If you would like to add
your read of these images, please email 'antiemetic@trauma.org'.
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