LEARNING POINTS: To discuss different non-traumatic vascular injuries and the most appropriate imaging strategy.
MAIN BODY: Acute vascular emergencies can arise from direct traumatic injury to the vessel or be spontaneous (non-traumatic). The vascular injuries can be arterial and venous. The findings of various types of vessel injuries include laceration with active hemorrhage, occlusion, and, for arteries, formation of pseudoaneurysm and dissection. Most of them are life-threatening emergencies, since they may cause an important hypovolemic shock or severe ischemia and require prompt diagnosis and treatment. In the different clinical scenarios, the correct diagnostic approach to vascular injuries is not firmly established and advantages of one imaging technique over the other are not obvious. Ultrasound is an easily accessible, safe and non-invasive diagnostic modality and is presently considered with the use of Doppler duplex sonography, the first-line examination for evaluation of vascular injuries.
CONCLUSION: Computed tomography with multiphasic imaging study is an accurate modality to evaluate the abdominal vascular injuries, quick to perform, non-invasive, readily available and able to visualize other anatomical structures simultaneously. Certainly, CT can be considered the primary imaging modality in a polytraumatic patient with suspicious vascular trauma.
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