Effect of CT information on the diagnosis and management of acute abdominal injury in children.

Neish, Ariane Staub; Taylor, George J.; Lund, Dennis P.; Atkinson, C C

doi:10.1148/radiology.206.2.9457182

Cited by 52 publications

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“…Ada beberapa alat bantu diagnosis yang telah digunakan untuk menunjang penegakan diagnosis cedera organ intra abdomen yaitu lavase peritoneal diagnosis, ultrasonografi (USG), CT Scan dan laparoskopi (3,4,5). Lavase peritoneal diagnosis (LPD) suatu metode untuk menunjang menegakkan diagnosis dari cedera intra abdomen telah digunakan secara luas karena dianggap cukup obyektif dalam menilai adanya cedera intra abdomen.…”

Section: Pendahuluanunclassified

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Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Soemarko

2013

JKB

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The diagnosis of intraperitoneal hemorrhage must be quickly with a high accuracy, before an acute exploratory laparotomy. This study was conducted to find out if intravesical pressure measurement should be as an alternative indicator of diagnostic peritoneal lavage in predicting intraperitoneal hemorrhage that indicating an acute exploratory laparotomy. Using an Explorative, Cross Sectional Design. Results of the exploratory laparotomy were used as a standard of determining the accuracy of Diagnostic Peritoneal Lavage and intravesical pressure measurement in predicting the indication for the exploratory laparotomy. 18 of 24 patients has positive results of diagnostic peritoneal lavage, but an active intraperitoneal hemorrhage only found in 15 patients, with a positive predictive value 83,33 %, negative predictive value 100%. The results of intravesical pressure measurement in the same patients predicted 17 patients has positive results, with slight a higher positive predictive value (88,24 %), negative predictive value 100%. The conclusion is the measurement of intravesical pressure is an alternative procedure of Diagnostic Peritonel lavage for predicting intraperitoneal hemorrhage.Key words: Blunt Trauma Abdomen; Intravesical Pressure Measurement; Diagnostic Peritoneal Lavage; Exploratory Laparotomy; Intraperitoneal Hemorrhage. PENDAHULUANPada cedera fisik yang memerlukan tindakan pembedahan akut didapatkan bahwa 10% diantaranya adalah akibat dari trauma tumpul didaerah abdomen. Trauma tumpul abdomen dapat menyebabkan cedera organ intra abdomen berupa ruptura organ padat seperti hepar dan lien atau perforasi organ berongga seperti lambung dan usus.Cedera intra abdomen pada pemeriksaan awal sulit untuk dideteksi. Apalagi bila penderita datang dalam keadaan tak sadar akibat trauma didaerah kepala atau akibat intoksikasi alkohol. Berdasarkan data yang berasal dari rekam medis diketahui bahwa 20% penderita dengan hemoperitoneum menunjukkan tanda tanda klinis yang benigna pada waktu pertama kali tiba di instalasi rawat darurat (1). Oleh karena itu untuk memberikan perawatan penderita secara optimal haruslah dimulai dengan evaluai awal yang teliti dengan melakukan prosedur bedah yang efektif dan efisien dalam waktu sehingga dapat secara maksimal diupayakan penyelamatan nyawa penderita. Harus diusahakan dengan benar untuk mencegah kematian yang memang seharusnya tidak terjadi (2).Untuk menegakkan diagnosis pada cedera organ pada trauma tumpul abdomen dapat menimbulkan keragu-raguan bagi ahli bedah. Tanda tanda klinis tidak selalu patognomonis menunjukkan adanya cedera organ intra abdomen. Berbeda dengan trauma terbuka atau tembus pada abdomen, pada trauma tumpul abdomen diperlukan langkah diagnosis yang lebih kompleks mengingat berbagai bentuk cedera dapat terjadi (2). Pada keadaan klinis yang meragukan dibutuhkan alat bantu tertentu untuk menegakkan diagnosis adanya cedera organ intra abdomen, sehingga dapat ditentukan ada tidaknya indikasi untuk melakukan laparotomi.Ada beberapa alat bantu diagnosis yang tel...

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Section: Pendahuluanunclassified

“…Tetapi ketersediaannya sangat terbatas di Indonesia disamping lebih invasif serta mahal dan memerlukan operator yang terlatih dan ahli dibidangnya (4,5).…”

Section: Pendahuluanunclassified

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Soemarko

2013

JKB

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“…Abdominal ultrasonography is more economical, less time consuming, noninvasive and can be repeated. There are various studies which have demonstrated increased sensitivity of computed tomography in identifying intra-abdominal injuries [6,7] . Although more costly and involves radiation, computed tomography is now extensively used in hemodynamically stable patients for accurate assessment of abdominal viscera especially in continuing bleeding and identification of co-existent bony and hollow visceral injury.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of Multidetector Computed Tomography in Evaluation of Blunt Abdominal Injury

Pradeep¹

2017

jmscr

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“…CT provides exact location of injury and its extent, so trend towards conservative management of liver, spleen and kidney injuries is increasing and also number of negative laparotomies are reduced. (2) "Focused Assessment with Sonography for Trauma" (FAST) is a method to detect intraperitoneal fluid in an emergency setting. Second generation ultrasound with improved resolution and multiple frequency probes improve the specificity of ultrasound evaluation in blunt abdominal trauma.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Multidetector Computed Tomography and Ultrasonography Findings in Blunt Abdominal Trauma

Devi¹,

Singh²,

Singh³

2016

jemds

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BACKGROUNDBlunt abdominal trauma usually has low sensitivity on physical examination and also subtle clinical manifestations. Improved resolution of the ultrasound machines and availability of multiple frequency probes has improved the specificity of ultrasound evaluation in blunt abdominal trauma. Despite this about 50% of the solid organ injuries are missed. Computed tomography has been used with better specificity to evaluate patients with blunt abdominal trauma who are FAST (Focused Assessment with Sonography for Trauma) positive as well as indeterminate and clinically suspicious cases of solid organ, hollow viscera, spine and pelvic injury.

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Effect of CT information on the diagnosis and management of acute abdominal injury in children.

Abstract: Abdominal CT had a strong effect on surgeons' clinical diagnoses and initial treatment plans in children with blunt trauma. CT information enabled surgeons to safely reduce the intensity of care provided to injured children.

Cited by 52 publications

References 0 publications

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Diagnostic accuracy of Multidetector Computed Tomography in Evaluation of Blunt Abdominal Injury

Comparative Study of Multidetector Computed Tomography and Ultrasonography Findings in Blunt Abdominal Trauma

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