The role of computed tomography after emergent trauma operation

Matsushima, Kazuhide; Inaba, Kenji; Dollbaum, Ryan; Khor, Desmond; Jhaveri, Vidhi; Jimenez, Omar F.; Strumwasser, Aaron; Δημητριάδης, Δημήτριος

doi:10.1016/j.jss.2016.08.033

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…If a repeat FAST examination or DPA is negative, workup for other sources of hemodynamic instability should continue. Computed tomography (CT) imaging after an emergent operative intervention could help identify additional injuries, even if they might not warrant subsequent interventions 7,8 . Patients with a positive FAST examination who are responding to blood transfusion resuscitation using contemporary hemodynamic monitoring and end points of resuscitation 9 should undergo contrast-enhanced CT imaging.…”

Section: Algorithmmentioning

confidence: 99%

Adult blunt hepatic injury: A Western Trauma Association critical decisions algorithm

Keric,

Shatz,

Schellenberg

et al. 2023

J Trauma Acute Care Surg

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Section: Algorithmmentioning

confidence: 99%

Adult blunt hepatic injury: A Western Trauma Association critical decisions algorithm

Keric,

Shatz,

Schellenberg

et al. 2023

J Trauma Acute Care Surg

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“…In patients with abdominal trauma who are hemodynamically stable, CT with intravenous contrast material is the imaging modality of choice (17), but the optimal use of imaging in patients undergoing DCS without preoperative imaging is an area of continued study (18)(19)(20)(21)(22)(23). A CT examination performed in the early perioperative period may allow identification of injuries that require additional intervention or occult injuries in or beyond the surgical field and may provide the potential to change the patient treatment plan.…”

Section: Imaging After Dcsmentioning

confidence: 99%

“…A CT examination performed in the early perioperative period may allow identification of injuries that require additional intervention or occult injuries in or beyond the surgical field and may provide the potential to change the patient treatment plan. Recent studies have shown that approximately 10%-30% of patients who undergo DCS undergo CT within 48 hours of surgery (19,(21)(22)(23).…”

Section: Imaging After Dcsmentioning

confidence: 99%

“…In 45 patients, previously undiagnosed fractures were identified. In another retrospective study (22) of 89 patients who underwent emergency exploration of the neck, thorax, or peritoneal cavity followed by CT within 48 hours of surgery, the authors identified new injuries in 66% of patients, most commonly spine and rib fractures. Twentyone injuries were in the same body region as the emergency surgery, six of which were considered clinically substantial enough to warrant a change in treatment.…”

Section: Imaging After Dcsmentioning

confidence: 99%

“…The examination provides an assessment of body parts not necessarily included in the initial surgical exploration. Clinically occult injuries have been found in 21%-66% of patients at CT after DCS (21)(22)(23) and may change patient treatment (Figs 14, 18; Movies 7-9). Use of the American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) can standardize communication, although this imaging grading system has shown inconsistent correlation with intraoperative findings (65,66).…”

Section: Diagnostic Challengesmentioning

confidence: 99%

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Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries

et al. 2019

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After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as damage control surgery (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient's condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24-48 hours of the initial surgery. Knowledge of this treatment plan is critical to CT interpretation, because there are anatomic derangements and foreign bodies that would not be present in patients undergoing surgery for other reasons. Patients may have injuries beyond the surgical field that are only identified at imaging, which can alter the care plan. Abnormalities related to the resuscitation period such as the CT hypoperfusion complex and ongoing hemorrhage can be recognized at CT. Familiarity with these imaging and clinical findings is important, because they can be seen not only in trauma patients after DCS but also in other patients in the critical care setting. The interpretation of imaging studies can be helped by an understanding of the diagnostic challenges of grading organ injuries with surgical materials in place and the awareness of potential artifacts on images in these patients.

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Pediatric Blast Injuries

Trappey

Cannon

2020

Operational and Medical Management of Explosive and Blast Incidents

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The role of computed tomography after emergent trauma operation

Cited by 6 publications

References 18 publications

Adult blunt hepatic injury: A Western Trauma Association critical decisions algorithm

Adult blunt hepatic injury: A Western Trauma Association critical decisions algorithm

Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries

Pediatric Blast Injuries

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