ORIGINAL RESEARCH n EMERGENCY RADIOLOGY Radiology: Volume 280: Number 3—September 2016 n radiology.rsna.org 735 1 From the Department of Radiology and Imaging Sciences (A.K.H., S.D.S.) and Department of Surgery (B.L.B.), Indi- ana University School of Medicine and Indiana University Health Methodist Hospital, 1701 N Senate Blvd, Room AG-176, Indianapolis, IN 46202. Received September 3, 2015; revision requested October 21; revision received December 14; accepted December 23; final version accepted December 23. Address correspondence to A.K.H. (e-mail: akhaste@iupui.edu). q RSNA, 2016 Purpose: To determine the incidence of unexpected injuries that are diagnosed with computed tomography (CT) after emergent exploratory laparotomy for trauma and whether identification of such injuries results in additional surgery or angiography. Materials and Methods: This HIPAA-compliant retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. The trauma databases of two urban level 1 trauma centers were queried over a pe- riod of more than 5 years for patients who underwent ab- dominopelvic CT within 48 hours of emergent exploratory laparotomy for trauma. Comparisons were made between CT findings and those described in the surgical notes. De- scriptive statistics were generated, and 95% confidence intervals (CIs) were determined by using an exact method based on a binomial distribution. Results: The study cohort consisted of 90 patients, including both blunt and penetrating trauma victims with a median in- jury severity score of 17.5 (interquartile range, 9.25–34). Seventy-three percent (66 of 90) of patients sustained penetrating trauma, 82% (74 of 90) of whom were male. A total of 19 patients (21.1%; 95% CI: 13.2, 31.0) had additional injuries within the surgical field that were not identified during laparotomy. There were 17 unidentified solid organ injuries, and eight patients had active bleeding within the surgical field. Eight patients (8.9%; 95% CI: 3.9, 16.8) had unexpected injuries at CT that were sub- stantial enough to warrant additional surgery or angiog- raphy. In addition, previously undiagnosed fractures were found in 45 patients (50%; 95% CI: 39.3, 60.7). Conclusion: Performing CT after emergent exploratory laparotomy for trauma is useful in identifying unexpected injuries and confirming suspected injuries that were not fully explored at initial surgery. q RSNA, 2016 Adam K. Haste, MD Brian L. Brewer, MD Scott D. Steenburg, MD Diagnostic Yield and Clinical Utility of Abdominopelvic CT Following Emergent Laparotomy for Trauma 1 This copy is for personal use only. To order printed copies, contact reprints@rsna.org