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Title: Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study
Authors: Nitima Saksobhavivat
Kathirkamanathan Shanmuganathan
Alexis R. Boscak
Clint W. Sliker
Deborah M. Stein
Uttam K. Bodanapally
Krystal Archer-Arroyo
Lisa A. Miller
Thorsten R. Fleiter
Melvin T. Alexander
Stuart E. Mirvis
Thomas M. Scalea
Mahidol University
University of Maryland School of Medicine
Keywords: Medicine
Issue Date: 1-Nov-2016
Citation: European Radiology. Vol.26, No.11 (2016), 4107-4120
Abstract: © 2016, European Society of Radiology. Purpose: Neither the performance of CT in diagnosing penetrating gastrointestinal injury nor its ability to discriminate patients requiring either observation or surgery has been determined. Materials and methods: This was a prospective, single-institutional observational study of patients with penetrating injury to the torso who underwent CT. Based on CT signs, reviewers determined the presence of a gastrointestinal injury and the need for surgery or observation. The primary outcome measures were operative findings and clinical follow-up. CT results were compared with the primary outcome measures. Results: Of one hundred and seventy-one patients (72 gunshot wounds, 99 stab wounds; age range, 18–57 years; median age, 28 years) with penetrating torso trauma who underwent CT, 45 % were followed by an operation and 55 % by clinical follow up. Thirty-five patients had a gastrointestinal injury at surgery. The sensitivity, specificity, and accuracy of CT for diagnosing a gastrointestinal injury for all patients were each 91 %, and for predicting the need for surgery, they were 94 %, 93 %, 93 %, respectively. Among the 3 % of patients who failed observation, 1 % had a gastrointestinal injury. Conclusion: CT is a useful technique to diagnose gastrointestinal injury following penetrating torso injury. CT can help discriminate patients requiring observation or surgery. Key Points: • The most sensitive sign is wound tract extending up to gastrointestinal wall. • The most accurate sign is gastrointestinal wall thickening. • Triple-contrast CT is a useful technique to diagnose gastrointestinal injury. • Triple-contrast CT helps to discriminate patients requiring observation and surgery.
ISSN: 14321084
Appears in Collections:Scopus 2016-2017

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