Utility of enteric contrast material in abdominal penetrating trauma: A narrative review

Tan, V.; Mellnick, Vincent M.; Patlas, Michael N.

doi:10.1016/j.diii.2021.04.003

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…A major disadvantage of enteric contrast is the time delay necessary for enteric opacification, which is the rationale for using single-contrast CT, especially in our resource-constrained environment. The time delay can be up to 68 minutes, a delay further compounded by limited access to theatre [ 21 ]. Delayed surgical intervention can result in increased morbidity and mortality [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Mingoli [ 22 ] and colleagues demonstrated that a delay of > 6 hours in the treatment of a blunt HVI is an independent predictor of postoperative morbidity. Other concerns include the risk of aspiration, especially in patients who will proceed to laparotomy [ 4 , 21 ]. In addition, recent studies found that triple-contrast CT has a sensitivity equal to that of single-contrast CT in detecting HVI and that the addition of enteric contrast did not provide any diagnostic benefit [ 4 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of CT Scan for Detecting Hollow Viscus Injury in Penetrating Abdominal Trauma

2023

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Background In penetrating abdominal trauma, computed tomography (CT) is routinely performed to evaluate stable patients for selective non-operative management (SNOM). Triple-contrast CT (oral, rectal, and IV) has traditionally been used. However, due to its disadvantages, most trauma centres, including our unit at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), now perform single-contrast intravenous-only CT scans. We performed a retrospective review to determine the accuracy of single-contrast CT scans for detecting hollow viscus injuries (HVI) in penetrating abdominal trauma. Methods A retrospective review of all patients who presented to CMJAH with penetrating abdominal injuries was performed between 01 August 2017 and 31 August 2019 and were evaluated for SNOM with CT (IV contrast only). Patient records were reviewed to determine pertinent demographics, mechanism, and site of injury, as well as metabolic parameters. CT findings were compared to findings at laparotomy. Results A total of 437 patients met the inclusion criteria. The majority were male (92.7%), with a mean age of 31.5 yrs (SD 8.7). Injuries were predominantly due to stab wounds (72,5%, n = 317). CT scan was negative in 342 patients, of which 314 completed SNOM successfully. A total of 93 patients proceeded to laparotomy. CT had a sensitivity of 95.1%, specificity of 44.2%, positive predictive value of 57.4%, and negative predictive value of 92%. Conclusion Single-contrast CT in penetrating abdominal trauma is a valuable investigative tool in identifying patients for SNOM. Features of HVI on single-contrast CT are not very specific and should be interpreted along with other clinical factors including wound trajectory and serial abdominal examinations. Other associated injuries such as diaphragmatic and solid organ injuries should be considered in the final management plan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accuracy of CT Scan for Detecting Hollow Viscus Injury in Penetrating Abdominal Trauma

2023

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“…La modulación de corriente del tubo se aplica con 250 mAs y 120 kVp como estándar en la mayoría de los pacientes. (Tan et al, 2021) Figura 2 Lesión en el intestino delgado en trauma abdominal evidencia por Tomografía. (Tan et al, 2021) Brazilian Journal of Health Review, Curitiba, v. 6, n. 1, p. 1956-1968, jan./feb., 2023…”

Section: Efastunclassified

“…(Tan et al, 2021) Figura 2 Lesión en el intestino delgado en trauma abdominal evidencia por Tomografía. (Tan et al, 2021) Brazilian Journal of Health Review, Curitiba, v. 6, n. 1, p. 1956-1968, jan./feb., 2023…”

Section: Efastunclassified

Revisión bibliográfica: manejo del Trauma Penetrante de Abdomen

Daniel¹,

Reyna²,

Valencia³

et al. 2023

Braz. J. Hea. Rev.

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El trauma de abdomen es uno de los principales causas de morbilidad a nivel mundial. Las lesiones graves producto de este, son una de las primeras causas de discapacidad en todo el mundo. Anteriormente, durante muchos años la laparotomía de rutina para todas las heridas abdominales potencialmente penetrantes era el estándar de oro, hoy en día la disponibilidad diversas tecnologías y estudios permiten tener un abordaje distinto según el estado del paciente, y por ende el tratamiento quirúrgico está basado principalmente en los hallazgos clínicos y en los parámetros hemodinámicos. En la siguiente revisión bibliográfica se abordará el manejo del trauma penetrante de abdomen.

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CT-based diagnostic algorithm to identify bowel and/or mesenteric injury in patients with blunt abdominal trauma

Lansier

Bourillon²,

Cuénod

et al. 2022

Eur Radiol

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Utility of enteric contrast material in abdominal penetrating trauma: A narrative review

Cited by 3 publications

References 25 publications

Accuracy of CT Scan for Detecting Hollow Viscus Injury in Penetrating Abdominal Trauma

Accuracy of CT Scan for Detecting Hollow Viscus Injury in Penetrating Abdominal Trauma

Revisión bibliográfica: manejo del Trauma Penetrante de Abdomen

CT-based diagnostic algorithm to identify bowel and/or mesenteric injury in patients with blunt abdominal trauma

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