Background: Evaluation of blunt abdominal trauma is controversial. Computed tomography (CT) of the abdomen is commonly used but has limitations, especially in excluding hollow viscus injury in the presence of solid organ injury. To determine whether CT reports alone could be used to direct operative treatment in abdominal trauma, this study was undertaken.
Methods: The trauma database at Auckland City Hospital was accessed for patients who had abdominal CT and subsequent laparotomy during a five-year period. The CT scans were reevaluated by a consultant radiologist who was blinded to operative findings. The CT findings were correlated with the operative findings.
Results: Between January 2002 and December 2007, 1,250 patients were evaluated for blunt abdominal injury with CT. A subset of 78 patients underwent laparotomy, and this formed the study group. The sensitivity and specificity of CT scan in predicting hollow viscus injury was 55.33 and 92.06 % respectively. The positive and negative predictive values were 61.53 and 89.23 % respectively. Presence of free fluid in CT scan was sensitive in diagnosing hollow viscus injury (90 %). Specific findings for hollow viscus injuries on CT scan were free intraperitoneal air (93 %), retroperitoneal air (100 %), oral contrast extravasation (100 %), bowel wall defect (98 %), patchy bowel enhancement (97 %), and mesenteric abnormality (94 %).
Conclusions: CT alone cannot be used as a screening tool for hollow viscus injury. The decision to operate in hollow viscus injury has to be based on mechanism of injury and clinical findings together with radiological evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00268-012-1798-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Peritonitis following duodenal injury due to seatbelt trauma: A case manifesting immediately post-surgery for thoracolumbar fracture-dislocation.
Int J Surg Case Rep
January 2025
Department of Orthopedic Surgery, Naha City Hospital, Okinawa, Japan.
Introduction: Although abdominal organ damage due to motor vehicle accident is often evident immediately after the injury and urgent operation is performed, it has been reported that minor injuries such as hollow viscus may become apparent during the course of treatment and require urgent surgery.
Case Report: The Authors present the case of a 42-year-old female who developed peritonitis immediately after undergoing surgery for thoracolumbar fracture-dislocation caused by a traffic accident. The patient exhibited no abdominal symptoms, such as nausea, vomiting, or abdominal wall rigidity, and had no difficulty with oral intake preoperatively.
Management of spontaneous liver hemorrhage in vascular Ehlers Danlos syndrome: A case report.
Int J Surg Case Rep
January 2025
Department of Surgery, Vassar Brothers Medical Center, Nuvance Health, 45 Reade Pl, Poughkeepsie, NY 12601, United States of America.
Introduction: Vascular Ehlers Danlos syndrome (vEDS) is a heritable connective tissue disorder characterized by vascular, solid organ, and hollow viscus fragility. Herein we report a patient with vEDS who presented with a large spontaneous subcapsular liver hemorrhage. This case highlights the challenges associated with managing vEDS patients and discusses approaches to optimize their care.
View Article and Find Full Text PDFUropathogenic Pan-Drug-Resistant Providencia rettgeri Infection in a Patient With an Indwelling Urinary Catheter: A Case Report.
Cureus
November 2024
Microbiology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, IND.
This case report details the clinical management and implications of infection with pan-drug-resistant in a 50-year-old male admitted and diagnosed with acute peritonitis due to hollow viscus perforation, highlighting an emerging challenge in healthcare settings. Following emergency laparotomy and intensive care admission, the patient was catheterized to assist urine drainage and subsequent urine bacterial culture which yielded pan-drug-resistant , signifying a notable instance of nosocomial infection by a multi-drug-resistant organism. Despite the organism's resistance to broad-spectrum antibiotics, clinical improvement was observed with levofloxacin treatment, underlining the potential discrepancy between in vitro resistance patterns and in vivo response, particularly in urinary tract infections (UTIs) where urine drug concentrations are pivotal.
View Article and Find Full Text PDFSigmoid volvulus during pregnancy is an extremely rare condition that presents as intestinal obstruction and can lead to severe complications for both the mother and fetus if not promptly diagnosed and treated. To our knowledge, this is the first documented case in Yemen. We report a case of a 39-year-old pregnant woman at 32 weeks of gestation who presented with acute abdominal pain, constipation, and signs of peritonitis.
View Article and Find Full Text PDFDoes time to operating room affect outcomes after pediatric blunt hollow viscus injury? A Trauma Quality Improvement Program analysis.
J Trauma Acute Care Surg
November 2024
From the Department of General, Thoracic, and Fetal Surgery (W.R.J., A.L.M.C., R.H., M.A., M.L.N., G.N.), Children's Hospital of Philadelphia; and Department of General Surgery (W.R.J.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Blunt hollow viscus injuries (HVIs) are relatively rare and difficult to diagnose. Whether a delay in operative intervention impacts outcomes for pediatric patients with blunt HVI has not been investigated via analysis of multicenter databases.
Methods: We queried the Trauma Quality Improvement Program database from 2016 to 2020 for patients younger than 18 years who underwent an operation of the stomach, small intestine, large intestine, or rectum within 72 hours of emergency department arrival after blunt injury.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!