 Good evening. My topic for the paper presentation is role of multi-detected computed tomography in evaluation of the blunt abdominal trauma. So, as we know that blunt abdominal trauma is the leading cause of mortality and morbidity among all this group and identification of serious abdominal pathology is often challenging in cases of abdominal injury because of the initial clinical symptoms and signs usually don't correspond to the severity of the injury. So, my aim and objective for the study was to evaluate the effectiveness of the multi-detected comatocity in reduction of intra-abdominal injury in patient with the blunt abdominal trauma and to provide a valuable information that could accurately determine the choice of the management, whether we should go for operative management or we should go for the known operative management. Also, our objective was to correlate the computed tomography finding with either clinical observation or the follow-up with the regular CT scans or with the surgical findings. So, wherever it was required and wherever surgery was done. So, material and method was it was a prospective study which was conducted in Bukheim and Pune, for over eight months in which we included the 75 patients which were having the clinical suspicion or having the presentation of intra-abdominal injury with stable vitals and having a positive USC scan report. So, they were evaluated with 64 slides multi-detected tomography which we have in our institution. The findings were correlated with the clinical follow-up and the follow-up the CT scan and also with the surgical findings. So, again the free fluid quantification was done by using the federal and Jeffrey method and they were graded into small moderate and large quantity and individual organ injury were graded according to the OIS system and injury severity grades were given by Mirvish and Moret. So, all the hemodynamic unstable patient were excluded from the study because they will be having the obvious peritonal signs and the progression of abdominal distension and they were immediately taken for the surgery and were excluded from the study. So, technique for CT what we have used is we have done the scanning from the domes of the diaphragm until the pubic symphysis and the plane scans were followed by the intravenous contrast scans in suspended inspiration. For intravenous contrast enhancement 8200 ml of dynamic injection ultravis that we have used and in children the 300 milligram for a variety per kg body weight were demonstrated and axial section were taken. The section were taken in the arterial and portal venous phases. Delayed scans were not usually performed but only in the suspected cases of the renal and the bladder trauma we have done the delayed scans also. So, these are the flu illustrations in which the first image we are seeing with the left kidney is almost saturated kidney which is having the multiple lacerations and with the perinephric hematoma. The second image having the multiple liver lacerations with the hemoperitone. So, our result and observation of study was there that we have found that the mostly the bulk of the patient were male and usually young age group were involved between mostly in 21 to 40 age group that were about 51 percent. And more mode of injury was mostly RTA both in male and female and full from the height and assault were a bit higher site in the females. And as per the distribution of injury we have found that solid organ injury which were associated with hemoperitone which was about of 70 percent. And the distribution of the visceral injury we have found that the spleen was the most injured organ in the most of the cases of aprolent abdominal trauma. Also in this study we have we had the 73 visceral injury reported and a majority of them 49 which were about 85 percent were having the visceral injury and have the peritoneum. About of eight cases out of visceral injuries which were not associated with the hemoperitoneum and two cases of them which one was GB injury and one was intraperitoneal rupture of the bladder. Six cases which were having renal injury with only the perinephric collection. So, out of 57 nine cases were immediately taken for the surgery and they were managed conservatively. So, again the distribution of CT quantification on the hemoperitoneum we have done into the mild moderate and large amount in which moderate hemoperitoneum was mostly associated with a majority of the blunt injury trauma. And distribution management of the hemoperitoneum based on CT grading we have found that mostly the conservative management were had done for the moderate amount of the hemoperitoneum. So, CT quantification of hemoperitoneum which was done by the Fidel and Jeffries method and all the hemoperitoneum cases that was nine cases which were taken for the surgery they were confirmed and the abdominal only the additional bowel injury were reported into the three cases which was associated with isolated hemoperitoneum and in the CT severity actually was of the 100% in detecting the hemoperitoneum. So, our study have a significant result in term of the sensitivity and specificity. The sensitivity was 66.7 and 100% almost the specificity and positive productive value was 100% negative productive value was 94%. The accuracy of the study was 94.7%. So, as I told the maximum maximum patient were of the younger age group mainly male predominant and associated with more of RTE and which of most of them will having abdominal injury with the hemoperitoneum and the isolated hemoperitoneum were diagnosed in a few cases. So, most common injury organ was the spleen and the CT finding which were we having the hemoperitoneum were confirmed and and also there were addition bowel injury was found into the isolated hemoperitoneum of the three cases. So, conclusion of my study was that CT was 100% sensitive in the detecting hemoperitoneum and all cases were conservatively had an uneventful recovery during the fall off period. So, in all the analysis of the solid organ injury in our study, why is grading system predicted management protocol in majority of our patients expect for those who are having the associated additional bowel and misery injury. So, in conclusion, we have found that CT is a best and a superior diagnostic mentality in diagnosing the management of the blunt abdomen. So, this concludes my presentation. Thank you. These are my references.