Comparison between isolated serial clinical examination and computed tomography for stab wounds in the anterior abdominal wall

Breigeiron, Ricardo; Breitenbach, Tiago Cataldo; Zanini, Lucas Adalberto Geraldi; Corso, Carlos Otávio

doi:10.1590/0100-69912017006009

Cited by 4 publications

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is usually not continued after 24 hours in penetrating trauma. However, in blunt trauma the duration of observation is not well defined [5,6]. CT scan of the abdomen is an equally important investigation.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Splenic Infarction and Pulmonary Embolism: A Case Report of Rare Radiological Finding

Sinha¹,

Mohakud²

2021

Cureus

View full text Add to dashboard Cite

Focused abdominal sonography in trauma (FAST) and contrast-enhanced computed tomography (CECT) abdomen are important radiological tests for evaluating the abdomen in polytrauma cases. When vitals are stable, they help to reach a diagnosis in the majority of patients. However, in a small number of cases they fail to explain the clinical scenario. A continued serial clinical assessment may be helpful in these circumstances. A polytrauma patient was found to be FAST positive. The CT scan revealed pulmonary embolism, splenic infarction, perisplenic and perihepatic hematoma. The patient was complaining of pain abdomen and it worsened on day three of the injury. An exploratory laparotomy was performed. A circumferential intestinal wall hematoma with a tear in mesentery was found. This is a rare case of traumatic splenic infarction with evidence of pulmonary embolism. The serial clinical assessment was helpful as it indicated the need for intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Traumatic Splenic Infarction and Pulmonary Embolism: A Case Report of Rare Radiological Finding

Sinha¹,

Mohakud²

2021

Cureus

View full text Add to dashboard Cite

show abstract

Evaluation and management of abdominal stab wounds: A Western Trauma Association critical decisions algorithm

Martin

Brown

Shatz

et al. 2018

J Trauma Acute Care Surg

View full text Add to dashboard Cite

This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with abdominal stab wounds. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithm and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this as a guideline to develop their own local protocols.

show abstract

Does computed tomography scan add any diagnostic value to the evaluation of stab wounds of the anterior abdominal wall? A systematic review and meta-analysis

Gachabayov

Gogna

Samson

et al. 2020

J Trauma Acute Care Surg

View full text Add to dashboard Cite

BACKGROUND The aim of this systematic review and meta-analysis was to evaluate whether computed tomography (CT) scan adds any diagnostic value in the evaluation of stab wounds of the anterior abdominal wall as compared with serial clinical examination (SCE). METHODS PubMed, EMBASE, Cochrane Library, and MEDLINE via Ovid were systematically searched for records published from 1980 to 2018 by two independent researchers (M.G., R.L.). Quality assessment, data extraction, and analysis were performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Mantel-Haenszel method with odds ratio (OR) and 95% confidence interval (95% CI) as the measure of effect size was used for meta-analysis. RESULTS Three studies (1 randomized controlled trial and 2 observational studies) totaling 319 patients were included in the meta-analysis. Overall laparotomy rate was 12.8% (22 of 172 patients) in SCE versus 19% (28 of 147 patients) in CT. This difference was not significant (OR [95% CI], 0.63 [0.34–1.16]; p = 0.14). Negative laparotomy rate was 3.5% (6 of 172 patients) in SCE versus 5.4% (8 of 147 patients) in CT. The difference was not significant (OR [95% CI], 0.61 [0.20–1.83]; p = 0.37). CONCLUSION This meta-analysis compared SCE with CT scan in patients presenting with stab wounds of the anterior abdominal wall and provided level II evidence showing no additional benefit in CT scan. Further observational and experimental clinical studies are needed to confirm the findings of this meta-analysis. LEVEL OF EVIDENCE Systematic review and meta-analysis, level II.

show abstract

Comparison between isolated serial clinical examination and computed tomography for stab wounds in the anterior abdominal wall

Cited by 4 publications

References 27 publications

Traumatic Splenic Infarction and Pulmonary Embolism: A Case Report of Rare Radiological Finding

Traumatic Splenic Infarction and Pulmonary Embolism: A Case Report of Rare Radiological Finding

Evaluation and management of abdominal stab wounds: A Western Trauma Association critical decisions algorithm

Does computed tomography scan add any diagnostic value to the evaluation of stab wounds of the anterior abdominal wall? A systematic review and meta-analysis

Contact Info

Product

Resources

About