Utility and Impact of Contrast-Enhanced Computed Tomography in Abdominal and Pelvic Vascular Emergencies – Our Experience

A BSTRACT Background: Abdominal vascular emergencies, either traumatic or spontaneous, can be life-threatening if not diagnosed and treated promptly. Multidetector computed tomography (MDCT) enables evaluation of acute vascular pathologies, vessel disruption, bleeding sources, and organ damage, facilitating swift and accurate treatment decisions. MDCT is crucial in assessment of the extent and severity of traumatic vascular injuries, leading to effective management and reduced complications. Aims and Objectives: The role of MDCT in identifying and characterizing various emergent vascular pathologies of the abdomen and pelvis was evaluated with assessment of its impact on patient management. Material and Methods: A prospective descriptive observational study was carried out involving 106 patients with acute abdominal or pelvic vascular findings who underwent multiphase MDCT, including angiography. The study recorded vascular involvement and associated complications, correlating these findings with surgical or clinical outcomes and follow-up results. Results: Pancreatitis-related vascular complications (26.4%) and nontraumatic acute vascular thrombosis (24.5%) were the most common pathologies, followed by aortic dissection (13.2%) and aortic aneurysm (11.3%). CT findings of active leaks and hematomas showed 100% correlation, and bowel ischemia showed 78.6% correlation with intraoperative findings. CT diagnosis guided the patient management wherein 42/106 (39.6%) underwent surgery, 49/106 (46.2%) were managed conservatively, and 4 (3.77%) patients were managed by interventional radiological procedures. Conclusion: MDCT is instrumental in the diagnosis of traumatic and nontraumatic abdominal vascular emergencies due to its capacity to increase diagnostic precision and evaluate associated complications, guide and expedite treatment, and ultimately improve patient outcomes.