The Prevalence, Distribution, and Clinical Significance of Incidental Findings Detected on Abdominal Computed Tomography of Trauma Patients.

Background

Incidental findings on abdominal CT are common in trauma patients and may have clinical importance.

Aim

To determine the prevalence and evaluate the clinical significance of incidental findings on abdominal CT in trauma patients and analyze their distribution by organ system.

Methods

This retrospective study included trauma patients who presented to the emergency department between June 2018 and May 2021 and underwent abdominal CT. Incidental findings were classified into three groups according to clinical significance: Group I, benign findings not requiring follow-up; Group II, likely benign findings that may require nonurgent follow-up; and Group III, indeterminate or suspicious findings requiring further diagnostic work-up.

Results

A total of 336 patients were included (mean age, 41.4 ± 21.3 years; 69.9% male). At least one incidental finding was identified in 61.6% ( n = 207) of patients, and the prevalence increased significantly with age ( P < 0.001). The kidneys were the most frequently affected system (28.0%), followed by vascular structures (22.9%), with percentages calculated using the total study population ( n = 336) as the denominator. Although the overall frequency of incidental findings did not differ significantly by sex ( P = 0.097), atherosclerotic vascular changes ( P = 0.046), gallbladder pathologies ( P = 0.012), and splenic findings ( P = 0.035) were more frequent in females. Group I lesions were present in 69.6% of patients with incidental findings, whereas Group II and Group III lesions were found in 29.5% and 4.8%, respectively. The most common individual findings were atherosclerotic vascular changes (14.9%), simple renal cysts (10.6%), and hiatal hernias (9.2%).

Conclusion

Incidental abdominal CT findings increased significantly with age. Although most were benign, a clinically relevant minority required nonurgent evaluation or further diagnostic investigation.