Publication: Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study
Issued Date
2016-11-01
Resource Type
ISSN
14321084
09387994
09387994
Other identifier(s)
2-s2.0-84961206154
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Radiology. Vol.26, No.11 (2016), 4107-4120
Suggested Citation
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 Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study. European Radiology. Vol.26, No.11 (2016), 4107-4120. doi:10.1007/s00330-016-4260-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/41034
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study
Other Contributor(s)
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.