Imaging of Penetrating Torso Trauma

Zeidenberg, Joshua; Durso, Anthony M.; Caban, Kim; Múnera, Felipe

doi:10.1053/j.ro.2016.03.004

Cited by 8 publications

(7 citation statements)

References 86 publications

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“…In our material, SWs were the most common cause of penetrating abdominal trauma and young men were most often involved, which is in accordance with studies from other European countries (15–17). However, in studies based on patient data from the United States, GSWs tend to be more prevalent (5,8,9).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, penetrating trauma has become evident on a larger scale following an increased risk of terrorist acts worldwide with explosive devices leading to blast injuries and mass casualties with preponderance of penetrating injuries (3,4). Computed tomography (CT) has an established role in the diagnosis of hemodynamically stable patients presenting with penetrating trauma to the torso while hemodynamically unstable patients often require immediate treatment for their injuries (2,5). For stable patients, general recommendations include a CT scan from the thoracic inlet to the greater trochanters with intravenous contrast material in arterial phase and portal venous phase series of the abdomen (2,5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography (CT) has an established role in the diagnosis of hemodynamically stable patients presenting with penetrating trauma to the torso while hemodynamically unstable patients often require immediate treatment for their injuries (2,5). For stable patients, general recommendations include a CT scan from the thoracic inlet to the greater trochanters with intravenous contrast material in arterial phase and portal venous phase series of the abdomen (2,5,6). An additional late phase scan is recommended for suspected trauma to the urinary tract, as well as a cystogram for the detection of urinary bladder injuries (2,5,6).…”

Section: Introductionmentioning

confidence: 99%

“…For stable patients, general recommendations include a CT scan from the thoracic inlet to the greater trochanters with intravenous contrast material in arterial phase and portal venous phase series of the abdomen (2,5,6). An additional late phase scan is recommended for suspected trauma to the urinary tract, as well as a cystogram for the detection of urinary bladder injuries (2,5,6). Following penetrating abdominal trauma, the use of gastrointestinal (GI) contrast material for diagnosis of hollow viscus injuries (HVI) is somewhat varied between different trauma centers, and as yet no consensus for its use exists (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of CT and the use of GI contrast material for detection of hollow viscus injury after penetrating abdominal trauma. Experience from a level 1 Nordic trauma center

et al. 2020

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Background Use of gastrointestinal (GI) contrast material for computed tomography (CT) diagnosis of hollow viscus injury (HVI) after penetrating abdominal trauma is still controversial. Purpose To assess the sensitivity of CT and GI contrast material use in detecting HVI after penetrating abdominal trauma. Material and Methods Retrospective analysis (2013–2016) of patients with penetrating abdominal trauma. Data from the local trauma registry, medical records, and imaging from PACS were reviewed. CT and surgical findings were compared. Results Of 636 patients with penetrating trauma, 177 (163 men, 14 women) had abdominal trauma (mean age 34 years, age range 16–88 years): 155/177 (85%) were imaged with CT on arrival; 128/155 (83%) were stab wounds and 21/155 (14%) were gunshot wounds; 47/155 (30%) had emergent surgery after CT. Two patients were imaged using oral, rectal and i.v. contrast; 23 with rectal and i.v. contrast; and 22 with i.v. contrast only. Surgery revealed HVI in 26 patients. CT had an overall sensitivity 69.2%, specificity 90.5%, PPV 90.0%, and NPV 70.4%. CT with oral and/or rectal contrast (n = 25) had sensitivity 66.7%, specificity 71.4%, PPV 85.7%, and NPV 45.5%. CT with i.v. contrast only (n = 22) had 75% sensitivity, 100% specificity, PPV 100%, and NPV 87.5%. No statistically significant difference was found between sensitivity of CT with GI contrast material and i.v. contrast only ( P = 1). Conclusion Stab wounds were the most common cause of penetrating abdominal trauma. CT had 69.2% sensitivity and 90.5% specificity in detecting HVI. CT with GI contrast had similar sensitivity as CT with i.v. contrast only.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of CT and the use of GI contrast material for detection of hollow viscus injury after penetrating abdominal trauma. Experience from a level 1 Nordic trauma center

et al. 2020

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“…Although blunt injury is more common than penetrating injury, the imaging features of penetrating trauma have been more extensively reviewed in the radiology literature (9)(10)(11)(12)(13). For this reason, we focus on the abdominal wall injuries that occur after nonpenetrating trauma, which have not been comprehensively reviewed previously, to our knowledge.…”

Section: Anatomy Of the Abdominal Wallmentioning

confidence: 99%

Don’t Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma

et al. 2017

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Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. RSNA, 2017.

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Usefulness of CT-scan in the management of chest stab trauma: a prospective observational study

Augustin

Guivarch

Tran-Dinh

et al. 2019

Eur J Trauma Emerg Surg

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Imaging of Penetrating Torso Trauma

Cited by 8 publications

References 86 publications

Diagnostic performance of CT and the use of GI contrast material for detection of hollow viscus injury after penetrating abdominal trauma. Experience from a level 1 Nordic trauma center

Diagnostic performance of CT and the use of GI contrast material for detection of hollow viscus injury after penetrating abdominal trauma. Experience from a level 1 Nordic trauma center

Don’t Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma

Usefulness of CT-scan in the management of chest stab trauma: a prospective observational study

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