CT imaging of clinically significant abdominopelvic injuries in the damage control surgery patient.

Purpose: Damage Control Surgery (DCS) refers to a staged laparotomy performed in patients who have suffered severe blunt or penetrating abdominopelvic trauma with the goal of managing critical injuries while avoiding life threatening metabolic derangements. Within 24 h of the initial laparotomy, computed tomography (CT) is used to assess the full extent of injuries. The purpose of this study was to assess the incidence of clinically significant unknown abdominopelvic injuries which required further dedicated surgical or interventional radiology management and failed surgical repairs identified on CT following initial laparotomy.

Evaluating the impact of surgical supply cost variation during partial nephrectomy on patient outcomes.

Background: Reducing surgical supply costs can help to lower hospital expenditures. We aimed to evaluate whether variation in supply costs between urologic surgeons performing both robotic or open partial nephrectomies is associated with differential patient outcomes.

Methods: In this retrospective cohort study, we reviewed 399 consecutive robotic (n=220) and open (n=179) partial nephrectomies performed at an academic center.

Updated guidelines for intravenous contrast use for CT and MRI.

Intravenous (IV) contrast material is used extensively for CT and MRI scans done in emergency departments (ED). Its use is essential to make many critical diagnoses in ED patients. While adverse reactions can occur, newer research has added to our knowledge of IV contrast media tolerance and safety leading to improved and more liberal guidelines for intravenous contrast use.

Differences in negative predictive value of prostate MRI based in men with suspected or known cancer.

Objective: To compare the negative predictive value (NPV) of multiparametric MRI for Gleason score (GS) ≥ 3+4 cancer and evaluate predictors of these tumors in men with suspected disease and under active surveillance (AS).

Materials And Methods: This retrospective study included 38 men with suspected prostate cancer and 38 under AS with scans assigned PI-RADS v2 scores 1 or 2 between May 2016 and September 2017. Biopsy results were no cancer, GS = 3+3, or GS ≥ 3+4.

Multidetector Computed Tomography Imaging of Damage Control Surgery Patients.

Damage control surgery is a staged surgical procedure in a patient who has suffered penetrating or blunt abdominal traumatic injury with severe metabolic derangements. Multidetector computed tomography scanning is a vital tool for patient management in the damage control patient, providing many uses, including assessing the extent of traumatic injury, evaluating areas that were not surgically explored, evaluating for injuries that were missed during the initial surgery, and assessing the stability of surgical repair. Understanding the postsurgical multidetector computed tomography appearance of these patients can aid the radiologist in protocol optimization and provide immediate accurate diagnoses.

Imaging Manifestations of Peptic Ulcer Disease on Computed Tomography.

Although the overall prevalence of peptic ulcer disease (PUD) has decreased in modern times, its actual incidence may be underestimated owing to the nonspecific clinical presentations patients' manifest. The potential lethal complications that can result from PUD include life-threatening abdominal hemorrhage and bowel perforation that result in significant morbidity and mortality. Computed tomography (CT) imaging historically lacks specificity in detecting PUD-related pathology in the stomach and proximal small bowel segments.

Utility of MDCT findings in predicting patient management outcomes in renal trauma.

Purpose: The purpose of this study is to assess the utility of computed tomography (CT) in predicting clinical outcomes in renal trauma.

Materials/methods: This retrospective study was IRB approved and HIPAA compliant; informed consent was waived. One-hundred-sixty-two, trauma-related renal injuries (157 adults) from January 01, 2006 to December 31, 2013 were included in this retrospective study.

Effect of an Institutional Triaging Algorithm on the Use of Multidetector CT for Patients with Blunt Abdominopelvic Trauma over an 8-year Period.

Purpose To evaluate the effect of an institutional clinical triaging algorithm on the rate of multidetector computed tomography (CT) utilization in blunt abdominopelvic trauma (BAPT) over an 8-year period at an urban level 1 trauma center. Materials and Methods Adult patients (n = 13 096; mean age, 42 years; age range, 15-95 years) admitted with BAPT from January 1, 2006, to December 31, 2013, were included. Patients with BAPT were divided into two groups: those admitted before (referred to as the prealgorithm group, from January 1, 2006, to June 30, 2010) and after (referred to as the postalgorithm group, from July 1, 2010, to December 31, 2013) the implementation of an institutional clinical triaging algorithm.

Damage control surgery: use of diagnostic CT after life-saving laparotomy.

Damage control surgery (DCS) is a limited exploratory laparotomy that is performed in unstable trauma patients who, without immediate intervention, would acutely decompensate. Patients usually present with shock physiology and metabolic derangements including acidosis, hypothermia, and coagulopathy. Delayed medical correction of these metabolic derangements leads to an irreversible state of coagulopathic hemorrhagic shock and inevitable patient demise.

CT of Major Vascular Injury in Blunt Abdominopelvic Trauma.

Blunt abdominopelvic trauma remains one of the leading causes of morbidity and mortality nationwide. Delays in diagnosis can be catastrophic, underscoring the crucial importance of prompt injury detection. Identification of vascular injuries in the setting of blunt abdominal trauma can pose a diagnostic challenge, as detection is reliant on appropriate multidetector computed tomography (CT) scanning protocols and familiarity with the various imaging presentations of vessel injury.