RadioGraphics -- eLetters for McGahan et al., 21 (90001) 191-199

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Helping the Trauma Surgeon:
John P. McGahan, Lianyi Wang, and John R. Richards
From the RSNA Refresher Courses: Focused Abdominal US for Trauma
Radiographics 2001; 21: S191-199S [Abstract] [Full text] [PDF]

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Electronic letters published:

Doppler US and Blunt Abdominal Trauma: Francisco Campoy-Balbontín M.D (15 January 2002)

Doppler US and Blunt Abdominal Trauma 15 January 2002

Francisco Campoy-Balbontín M.D,
Radiologist attending
Radiology department. La Merced Hospital. Avda de la Constitución 2. Osuna 41640, Spain
Send letter to journal:
Re: Doppler US and Blunt Abdominal Trauma

fcampoy2000{at}hotmail.com Francisco Campoy-Balbontín M.D

In the use of ultrasound (US) for evaluating blunt abdominal trauma, focused on the study of solid organ injuries (1), I think it is important to include routine use of color and power Doppler sonography, at least in the study of kidneys. In my own experience, I have seen how a completely normal-appearing kidney at US in a child involved in a car accident had sustained injury to the renal pedicle, resulting in loss of the organ. The diagnosis was made, too late, with color and pulsed Doppler 6 hours after the first US examination. So, if we are not going to perform computed tomography, I think it is mandatory to include in our US protocol color and power Doppler imaging of the kidneys.
Reference
1. McGahan JP, Wang L, Richards JR. From the RSNA refresher courses: focused abdominal US for trauma. RadioGraphics 2001; 21(special issue):S191-S199.
Drs McGahan, Wang, and Richards respond:
Dr Campoy-Balbontin makes an excellent point. There is a need for color or power Doppler US for detecting certain parenchymal injuries. His example of a complete renal pedicle injury, in which the kidney appeared normal during a real-time examination and where the injury was detected only with color Doppler imaging, nicely illustrates this point.