ABSTRACT

Computed tomography (CT) hypoperfusion complex is observed in the imaging findings of intra-abdominal organs and vascular structures during shock and hypoperfusion. The aim is to examine the frequency of CT hypoperfusion complex and etiologic factors by retrospectively analyzing the CT performed on patients admitted to emergency departments.

In our study, 930 abdomen and thorax tomographies were obtained from the patients admitted to our emergency department during a 1-year period. All CT scans were performed by using a 640-slice tomography device. The CT criteria for hypoperfusion complex included the small-caliber aorta and inferior vena cava (IVC), hyperdense bowel wall, surrenal enhancement, hypoperfused liver, spleen, and hyperdense kidney.

Our study revealed the presence of CT hypoperfusion complex in at least 1 of 15 patients (0.16%). We detected low-calibrated abdominal aorta together with hyperdense adrenal glands in all the CT hypoperfusion complex cases (15 cases, 0.16%). We found the presence of intra-abdominal free fluid in 13 cases (0.13%), halo sign in IVC in 8 cases (0.08%), hypoperfusion view of the spleen and liver in 5 cases (0.05%), pericholecystic fluid in 3 cases (0.03%), and sign of renal hyperperfusion (white kidney sign) in 3 cases (0.03%).

Our study showed that low-calibrated abdominal aorta and hyperdense adrenal glands were present in each patient showing CT hypoperfusion complex, and the assessment of these two structures is very important before the setting-in of irreversible shock.

Keywords: Computed tomography, hypoperfusion, shock