| Print Date: | May 24, 2013, 5:28 am |
| Title | Abdominal blast injury |
| Text | Injury patterns of blasts in recent conflicts have become more chaotic with the increased use of Improvised Explosive Devices (IEDs). Little has been published on detecting and reporting retained fragments. The authors further quantify retained fragment locations by a proposed anatomical polar coordinate system based on a single reference point. Magnitude from a reference point and 3D planar angle allows precise and consistent localization of remaining fragments. This is useful in consistently recording location of fragments. Since image data is occasionally unavailable during patient transfer, more accurate recording is paramount. Basically each fragment will have an “address” that will identify its precise location. Rather than street address, city, state and zip-code, each fragment will have a 3D “latitude / longitude” spatial quantification from a standard reference point, equator and zero meridian.
Weaknesses and limitations leading to difficulty in determining the wound path or recording fragments consistently on axial slices alone include the following: 1. Some believe that projectiles bounce unpredictably within the body; however, recent combat imaging experience shows otherwise. More research is needed in non-military, lower velocity missiles. 2. The path of blast or ballistic fragments often cannot be appreciated on traditional axial slices and organ damage is not completely assessed. 3. Lack of standard terminology for complex planes of trajectories interferes with effective communication for individual casualties and academic advancement. 4. Lack of consistent localization or reporting system leaves wounded warriors without record of remaining fragments in their body for accurate follow-up while active duty, after separation or retirement from military in the VA system for accurate disability evaluation. Using a standardized plane-based data acquisition and analysis approach, radiologists are able to precisely locate a fragment, estimate its size and delineate its 3-dimensional location which provides guidance for emergency physicians, trauma surgeons, and follow-up evaluations through the echelons of care. |
| References: | Harcke HT, Levy AD, Getz JM, Robinson SR. MDCT analysis of projectile injury in forensic investigation.
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| Contributor | Tatjana V Fischer (- Leave Blank -) |
| Peer Reviewer | Les R Folio (Uniformed Services University) |
| Record Number | : 9203 |
| Created | 2009-05-04 04:54:25-04 |
| Modified | 2009-05-04 08:39:22.231362-04 |
| Category: | Trauma |
| Location: | Multisystem |
| Sublocation: | None Selected |
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