Details

Autor(en) / Beteiligte

• Jost, Evan, MD
• Roberts, Derek J., MD, PhD
• Penney, Todd
• Brunet, Grant
• Ball, Chad G., MD, MSc, FRCSC, FACS
• Kirkpatrick, Andrew W., CD, MD, MHSc, FRCSC, FACS

Titel

Accuracy of Clinical, Laboratory, and Computed Tomography Findings for Identifying Hollow Viscus Injury in Blunt Trauma Patients with Unexplained Intraperitoneal Free Fluid without Solid Organ Injury

Ist Teil von

• The American journal of surgery, 2017-05, Vol.213 (5), p.874-880

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background We sought to define the accuracy of findings for detecting hollow viscus injury (HVI) in patients with blunt abdominal trauma (BAT) and unexplained intra-peritoneal free fluid without solid organ injury (UIPFFWSOI). Methods We screened all consecutive hemodynamically stable patients presenting to a quaternary-care trauma-centre who had an abdominal computed tomography (CT) scan for BAT and UIPFFWSOI (January 2007-December 2014). Results Of 3796 patients identified during the study period, 39 presented with UIPFFWSOI. Fifteen underwent therapeutic laparotomy. Seatbelt sign (+LR approaches infinity), diffuse peritonitis (+LR approaches infinity), number of CT cuts with fluid (c-statistic=0.65), and a lower arterial pH at presentation (c-statistic=0.62) were most predictive of HVI. Patients operated on within 24 hours had shorter stays than those operated on later (median 9 vs. 14 days, p=0.03). Conclusions Our findings suggest that clinical examination and measurements of intraperitoneal fluid volume may help identify HVIs in BAT patients. This study sought to define the accuracy of findings for detecting hollow viscus injury (HVI) in patients with blunt abdominal trauma (BAT) and unexplained intra-peritoneal free fluid without solid organ injury. Our findings suggest that clinical examination combined with measurements of intraperitoneal fluid volume may help identify HVIs in this patient population.