Incidental findings on computed tomography (CT) scan are defined as “findings unrelated to the chief complaint and not pertinent to the immediate patient care in the Emergency Department.”[1] A number of studies report the incidental findings on CT scan in patients (adults as well as children) who attended Emergency Department for trauma-related care (with or without traumatic brain injury [TBI]).[1,2,3] The findings may range from benign calcification (needs no intervention), some lesions may need regular follow up and a small number of the lesions may need urgent intervention (i.e., brain tumors).[1,4,5,6,7,8]
There is wide variation in the reported incidence of incidental findings mainly reflecting the nonuniformity in inclusion/exclusion criteria defining the different lesions that are visible on CT scan.[3,4,5,6,9] For example in a study, the authors did not include sinus disease (as fractures of the sinus wall can cause bleeding and simulate a sinus disease)[2,8] yet in another study apart from many other exclusion criteria the authors excluded age-related cerebral atrophy.[10] In contrary to this few studies (as well as a present study) included brain atrophy and sinus disease in their analysis.[2,11] Another very important fact that has not been studied and reported in greater details is “some incidental findings might have actually predisposed to TBI.”[8]
The present article[12] is yet another step to understand the incidence of incidental findings and the fact that “the article is from a resource poor setting” make this a unique and important contribution to the existing knowledge. Apart from this, the present study reflects that presently literature does not have consistent or uniform guidelines to address many issues in context of incidental findings on imaging including:
How to define incidental findings?
How to categorize incidental findings?
How to further investigate or manage these cases?
How to further follow up these cases? and
How to and how much to be disclosed to the patient and/or relatives?
Footnotes
Source of Support: Nil.
Conflict of Interest: None declared.
REFERENCES
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