Prospective Study of Computed Tomography in Initial Management of Blunt Abdominal Trauma

Peitzman, Andrew B.; Makaroun, Michel S.; Slasky, B. Simon; Ritter, Pamela

doi:10.1097/00005373-198607000-00001

Cited by 227 publications

(70 citation statements)

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“…It is most sensitive to detect grade III or above splenic injuries based on the presence of hemoperitoneum. In case of doubt, CT remains the gold standard for diagnosing and precisely assessing the severity of splenic injury, provided that the patient is stable [10,11].…”

Section: Discussionmentioning

confidence: 99%

Delayed Splenic Rupture: A Case Report and Literature Review

et al. 2017

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The spleen is one of the most commonly injured organs in the body after blunt abdominal trauma. Our objective was to present a case of the rare entity called "delayed splenic rupture", which is the delayed manifestation of splenic injury following a trauma in which the initial ultrasonography study was normal. We also review the previous 13 cases up to 2015 and offer our recommendations. We present a case of a 60-year-old male with a history of road traffic accident 3.5 days prior to admission to our hospital with initial normal ultrasonography scan done at a peripheral referring hospital. He was evaluated and proved to have a large subcapsular splenic hematoma and significant hemoperitoneum. He was offered splenectomy.

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Section: Discussionmentioning

confidence: 99%

Delayed Splenic Rupture: A Case Report and Literature Review

et al. 2017

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“…In the haemodynamically stable patient, performing CTAP in such patients may even allow them to be discharged from the emergency department due to its high negative predictive value. 1 In view that CTAP has a much higher sensitivity (92-98%) and specificity (99%) 2 as compared to FAST (sensitivity 73-88%, specificity 98-100%), 3 we wanted to evaluate if ultrasound would still be reliable and u s e f u l i n t h e m a n a g e m e n t o f t h e m u l t i p l y injured patient with blunt abdominal injury in our centre.…”

Section: Discussionmentioning

confidence: 99%

Focused Assessment with Sonography in Trauma (FAST): Experience of a Tertiary Hospital in Southeast Asia

Wong¹,

Ngo

Wee³

et al. 2014

Hong Kong Journal of Emergency Medicine

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Focused assessment with sonography in trauma (FAST): experience of a tertiary hospital in Southeast Asia創傷超聲重點評估（FAST）：東南亞一間三級醫院的經驗 E Wong 王怡玲, ASY Ngo 吳淑瑩, JCP Wee 黃俊評, JMH Lee 李美華 Objective: This study compares the positive predictive value (PPV) and negative predictive value (NPV) of focused assessment with sonography in trauma (FAST) versus abdominal-pelvic computed tomography scans (CTAP) after blunt abdominal injury as well as the need for abdominal surgery. We also sought to determine if any false negative ultrasound studies were associated with significant morbidity. The results were compared with other studies. Design: Retrospective cross-sectional study. Setting: A tertiary hospital. Methods: Cases were retrieved from the trauma registry and electronic medical records in a tertiary hospital in Singapore over a two year period from 1 January 2009 to 31 December 2010. Exclusion criteria included penetrating trauma and burns. The sonographic finding, computed tomography finding, and the outcome of the patients were retrieved. Diagnostic characteristics including predictive values were calculated. Results: A total of 476 patients were enrolled. Four hundred fifty-nine patients had FAST performed with fifty (10.9%) being positive. Forty-nine patients (21.7%) out of 226 patients had CTAP which showed abnormalities and nineteen (4.0%) patients underwent surgery. Comparing FAST to detect abnormalities on CTAP, the PPV and NPV were 0.590 and 0.863 respectively. Comparing FAST with the need for surgery, the PPV and NPV were 0.280 and 0.990 respectively. Four patients (0.98%) had negative FAST but required surgery. There were no significant adverse outcomes or surgical intervention in patients with normal vital signs, normal initial physical examination and negative FAST findings but who did not have a CTAP. Conclusions: In patients with an initial normal physical examination and negative FAST, emergent CTAP may be avoided. (Hong Kong j.emerg.med. 2014;21:230-236) 目的：本研究比較了創傷超聲重點評估（ FAST ）與腹腔 / 盆腔 CT 掃描（ CTAP ），在腹部閉合性損傷的陽性預測值（ P P V ）和陰性預測值（ NP V ），以及是否需要腹部手術。我們還試圖確定假陰性的超聲檢查，是否與有重大的併發症有關。並將結果與其他研究進行比較。設計：回顧性橫斷面研究。

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“…Abdominal CT scan have a reported sensitivity and specificity as high as 80% in diagnosing pancreatic injury, although the accuracy of this examination is largely dependent on interpreter experience, quality of the scanner and the time from injury 3,5 . It has the disadvantages of complicated usage, limited repeatability, and radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound (EUS) diagnosis of blunt pancreatic trauma associated to the superior mesenteric vein thrombosis

Artifon

Couto-Júnior

Fraga

et al. 2010

ABCD, arq. bras. cir. dig.

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-Background -Blunt pancreatic injuries occur when a high-energy crushing force is applied to the upper abdomen. In adults, the majority of blunt pancreatic injuries result from motor vehicle accidents. Case report -Male with 32 years old had a high-energy crushing history in witch he was pressured by the chest on the front car area. His life signs demonstrated to be regular. Ct scan demonstrated body pancreatic edema. All routine laboratorial exams were normal, EUS revealed pancreatic lesion grade II without involvement of the pancreatic duct and an impressive superior mesenteric vein thrombosis. He was sustained by means of anti-coagulation for about two months and after that time the multislice CT scan showed a mesenteric vein recanalization and a normal pancreatic parenchyma. The patient had an uneventfull follow-up. Conclusion -Patients presenting possible pancreatic trauma associated to superior mesenteric vein thrombosis, EUS must be used firstly.RESUMO -Introdução -Traumas pancreáticos fechados ocorrem em acidentes que promovem força intensa no abdome superior, principalmente em acidentes automobilísticos. Relato do caso -Homem de 32 anos foi jogado contra a área frontal de seu automóvel. Seus sinais vitais eram normais. CT mostrou edema pancreático. EUS mostrou lesão pancreática grau II sem envolvimento do ducto pancreático, mas com impressionante trombose da veia mesentérica superior. Ele foi mantido com anticoagulants por dois meses e após este period novo scan mostrou recanalização e pâncreas normal. Teve seguimento favorável. Conclusão -Paciente apresentando edema pancreático associado a possível trombose de veia mesentérica superior deve ser submetido à EUS para monitorização e acompanhamento.

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Prospective Study of Computed Tomography in Initial Management of Blunt Abdominal Trauma

Cited by 227 publications

References 0 publications

Delayed Splenic Rupture: A Case Report and Literature Review

Delayed Splenic Rupture: A Case Report and Literature Review

Focused Assessment with Sonography in Trauma (FAST): Experience of a Tertiary Hospital in Southeast Asia

Endoscopic ultrasound (EUS) diagnosis of blunt pancreatic trauma associated to the superior mesenteric vein thrombosis

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