Nitima SaksobhavivatKathirkamanathan ShanmuganathanAlexis R. BoscakClint W. SlikerDeborah M. SteinUttam K. BodanapallyKrystal Archer-ArroyoLisa A. MillerThorsten R. FleiterMelvin T. AlexanderStuart E. MirvisThomas M. ScaleaMahidol UniversityUniversity of Maryland School of Medicine2018-12-112019-03-142018-12-112019-03-142016-11-01European Radiology. Vol.26, No.11 (2016), 4107-412014321084093879942-s2.0-84961206154https://repository.li.mahidol.ac.th/handle/20.500.14594/41034© 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.Mahidol UniversityMedicineArticleSCOPUS10.1007/s00330-016-4260-3