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Objective:
To determine the incidence of abdominal incidentalomas detected on CT scans during trauma workups.
To determine whether patients with incidental lesions receive information regarding their findings.
Design:
Retrospective review of prospectively maintained trauma registry
Setting:
Level-1 University-based Trauma Center
Patients:
Adult trauma patients (>18 years) evaluated between 9/2011-8/2012 who received a CT abdomen during trauma evaluation.
Interventions:
Main Outcome Measures:
Incidentalomas were defined as newly diagnosed non-traumatic lesions detected on abdominal-pelvic CT scan as determined by the initial trauma radiologist read. Data was collected for kidney, liver, adrenal, ovary, and pancreas lesions. Patients were considered to have been “informed” of their lesion(s) if the finding was noted in discharge paperwork or if the patient received in-patient evaluation for the lesion. Follow-up consisted of in-patient consultation or outpatient follow-up with the appropriate specialist or primary care physician.
Results:
105(21%) of the 503 trauma patients with abdominal imaging had 130 lesions. Renal lesions were the most common(48%), followed by hepatic(30%), adrenal (17%), pancreatic(1%), and ovarian(<1%). Of surviving patients(n=92) with incidentalomas, 12(13%) had received documentation regarding the lesion. Compared to patients discharged from Orthopedics, Emergency Department, Medicine, or Neurosurgery, patients from the Trauma Service were more likely to receive information regarding the presence of the lesion(17%vs.0%,1%,0%,0%,p=0.02). Gender, race, and insurance status did not affect patients’ chances of receiving information regarding their incidental finding(s). Only 8.5% of patients with incidentalomas received documented follow-up.
Conclusions:
Abdominal incidentalomas are commonly diagnosed and most often affect the kidney, adrenals, and liver. Most trauma patients with such findings do not receive instruction regarding these lesions. Future efforts/protocols should be created to improve patient education and follow-up for these newly discovered lesions.