Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy
Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of...
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| Veröffentlicht in: | The American journal of surgery 2001-07, Vol.182 (1), p.6-9 |
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| creator | Livingston, David H Lavery, Robert F Passannante, Marian R Skurnick, Joan H Baker, Stephen Fabian, Timothy C Fry, Donald E Malangoni, Mark A |
| description | Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal CT after blunt abdominal trauma.
Methods: This study was a multicenter prospective series of all patients with blunt abdominal trauma admitted to four level I trauma centers over 22 months. Data were collected concurrently at the time of patient enrollment and included demographics, injury severity score, findings on CT scan, and presence or absence of blunt intestinal injury. This database was specifically queried for those patients who had free fluid without solid organ injury.
Results: In all, 2,299 patients were evaluated. Free fluid was present in 265. Of these, 90 patients had isolated free fluid with only 7 having a blunt intestinal injury. Conversely, 91% of patients with free fluid did not. All patients with free fluid were observed for a mean of 8 days (95% confidence interval 6.1 to 10.4, range 1 to 131). There were no missed injuries.
Conclusions: Free fluid on abdominal CT scan does not mandate celiotomy. Serial observation with the possible use of other adjunctive tests is recommended. |
| doi_str_mv | 10.1016/S0002-9610(01)00665-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71136558</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002961001006651</els_id><sourcerecordid>2847464616</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-367cb945295e0aaa144de40fdf2a3829fdee6602bdd298c9f12925d8267e2db03</originalsourceid><addsrcrecordid>eNqF0UFrFTEQB_Agin1WP4ISEIseVjPZbHZzKlKsCgUP6jlkk9k2j93NM8lW3sXPbl7fYsWLpxDym2Eyf0KeA3sLDOS7r4wxXikJ7DWDN4xJ2VTwgGyga1UFXVc_JJs_5IQ8SWlbrgCifkxOAJqaCyY35NdlRKTDuHhHw0xN78LkZzNSG6bdktHRHKZwHc3uZk9_-nwTlkxTGA88XpuZ-nm7xD01Q8ZI-3GZ819N1kcXMNE5ZDqZ2ZmM1OLoQ2m8f0oeDWZM-Gw9T8n3yw_fLj5VV18-fr54f1VZASpXtWxtr0TDVYPMGANCOBRscAM3dcfV4BClZLx3jqvOqgG44o3ruGyRu57Vp-Ts2HcXw48FU9aTT2WK0cwYlqRbgFo2TVfgy3_gNiyx_CVp3olWSCFBFtUclY0hpYiD3kU_mbjXwPQhHn0Xjz7sXjPQd_FoKHUv1u5LP6G7r1rzKODVCkyyZhyima1P964YXitV3PnRYVnarceok_U4W3Q-os3aBf-fUX4DKo2t0Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2847464616</pqid></control><display><type>article</type><title>Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>ProQuest Central UK/Ireland</source><creator>Livingston, David H ; Lavery, Robert F ; Passannante, Marian R ; Skurnick, Joan H ; Baker, Stephen ; Fabian, Timothy C ; Fry, Donald E ; Malangoni, Mark A</creator><creatorcontrib>Livingston, David H ; Lavery, Robert F ; Passannante, Marian R ; Skurnick, Joan H ; Baker, Stephen ; Fabian, Timothy C ; Fry, Donald E ; Malangoni, Mark A</creatorcontrib><description>Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal CT after blunt abdominal trauma.
Methods: This study was a multicenter prospective series of all patients with blunt abdominal trauma admitted to four level I trauma centers over 22 months. Data were collected concurrently at the time of patient enrollment and included demographics, injury severity score, findings on CT scan, and presence or absence of blunt intestinal injury. This database was specifically queried for those patients who had free fluid without solid organ injury.
Results: In all, 2,299 patients were evaluated. Free fluid was present in 265. Of these, 90 patients had isolated free fluid with only 7 having a blunt intestinal injury. Conversely, 91% of patients with free fluid did not. All patients with free fluid were observed for a mean of 8 days (95% confidence interval 6.1 to 10.4, range 1 to 131). There were no missed injuries.
Conclusions: Free fluid on abdominal CT scan does not mandate celiotomy. Serial observation with the possible use of other adjunctive tests is recommended.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/S0002-9610(01)00665-1</identifier><identifier>PMID: 11532406</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Abdominal Injuries - diagnosis ; Abdominal Injuries - diagnostic imaging ; Abdominal Injuries - surgery ; Adult ; Biological and medical sciences ; Blunt abdominal injury ; Body Fluids - diagnostic imaging ; Celiotomy ; Computed tomography ; Contusions ; Emergency medical care ; Female ; Free fluid ; Hollow viscus injury ; Humans ; Injuries ; Injuries of the abdomen. Foreign bodies of the digestive system ; Intestine ; Intestines - injuries ; Laparotomy ; Male ; Medical imaging ; Medical sciences ; Morbidity ; Patients ; Predictive Value of Tests ; Prospective Studies ; Reading ; Sensitivity and Specificity ; Solid organ injury ; Tomography ; Tomography, X-Ray Computed ; Trauma ; Traumas. Diseases due to physical agents ; Wounds, Nonpenetrating - diagnosis ; Wounds, Nonpenetrating - diagnostic imaging ; Wounds, Nonpenetrating - surgery</subject><ispartof>The American journal of surgery, 2001-07, Vol.182 (1), p.6-9</ispartof><rights>2001 Elsevier Science Inc.</rights><rights>2002 INIST-CNRS</rights><rights>2001. Elsevier Science Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-367cb945295e0aaa144de40fdf2a3829fdee6602bdd298c9f12925d8267e2db03</citedby><cites>FETCH-LOGICAL-c419t-367cb945295e0aaa144de40fdf2a3829fdee6602bdd298c9f12925d8267e2db03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2847464616?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974,64362,64364,64366,72216</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14062399$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11532406$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Livingston, David H</creatorcontrib><creatorcontrib>Lavery, Robert F</creatorcontrib><creatorcontrib>Passannante, Marian R</creatorcontrib><creatorcontrib>Skurnick, Joan H</creatorcontrib><creatorcontrib>Baker, Stephen</creatorcontrib><creatorcontrib>Fabian, Timothy C</creatorcontrib><creatorcontrib>Fry, Donald E</creatorcontrib><creatorcontrib>Malangoni, Mark A</creatorcontrib><title>Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal CT after blunt abdominal trauma.
Methods: This study was a multicenter prospective series of all patients with blunt abdominal trauma admitted to four level I trauma centers over 22 months. Data were collected concurrently at the time of patient enrollment and included demographics, injury severity score, findings on CT scan, and presence or absence of blunt intestinal injury. This database was specifically queried for those patients who had free fluid without solid organ injury.
Results: In all, 2,299 patients were evaluated. Free fluid was present in 265. Of these, 90 patients had isolated free fluid with only 7 having a blunt intestinal injury. Conversely, 91% of patients with free fluid did not. All patients with free fluid were observed for a mean of 8 days (95% confidence interval 6.1 to 10.4, range 1 to 131). There were no missed injuries.
Conclusions: Free fluid on abdominal CT scan does not mandate celiotomy. Serial observation with the possible use of other adjunctive tests is recommended.</description><subject>Abdomen</subject><subject>Abdominal Injuries - diagnosis</subject><subject>Abdominal Injuries - diagnostic imaging</subject><subject>Abdominal Injuries - surgery</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blunt abdominal injury</subject><subject>Body Fluids - diagnostic imaging</subject><subject>Celiotomy</subject><subject>Computed tomography</subject><subject>Contusions</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Free fluid</subject><subject>Hollow viscus injury</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injuries of the abdomen. Foreign bodies of the digestive system</subject><subject>Intestine</subject><subject>Intestines - injuries</subject><subject>Laparotomy</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Morbidity</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Reading</subject><subject>Sensitivity and Specificity</subject><subject>Solid organ injury</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Traumas. 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Foreign bodies of the digestive system</topic><topic>Intestine</topic><topic>Intestines - injuries</topic><topic>Laparotomy</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Morbidity</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Reading</topic><topic>Sensitivity and Specificity</topic><topic>Solid organ injury</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Wounds, Nonpenetrating - diagnosis</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><topic>Wounds, Nonpenetrating - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Livingston, David H</creatorcontrib><creatorcontrib>Lavery, Robert F</creatorcontrib><creatorcontrib>Passannante, Marian R</creatorcontrib><creatorcontrib>Skurnick, Joan H</creatorcontrib><creatorcontrib>Baker, Stephen</creatorcontrib><creatorcontrib>Fabian, Timothy C</creatorcontrib><creatorcontrib>Fry, Donald E</creatorcontrib><creatorcontrib>Malangoni, Mark A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Livingston, David H</au><au>Lavery, Robert F</au><au>Passannante, Marian R</au><au>Skurnick, Joan H</au><au>Baker, Stephen</au><au>Fabian, Timothy C</au><au>Fry, Donald E</au><au>Malangoni, Mark A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2001-07-01</date><risdate>2001</risdate><volume>182</volume><issue>1</issue><spage>6</spage><epage>9</epage><pages>6-9</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal CT after blunt abdominal trauma.
Methods: This study was a multicenter prospective series of all patients with blunt abdominal trauma admitted to four level I trauma centers over 22 months. Data were collected concurrently at the time of patient enrollment and included demographics, injury severity score, findings on CT scan, and presence or absence of blunt intestinal injury. This database was specifically queried for those patients who had free fluid without solid organ injury.
Results: In all, 2,299 patients were evaluated. Free fluid was present in 265. Of these, 90 patients had isolated free fluid with only 7 having a blunt intestinal injury. Conversely, 91% of patients with free fluid did not. All patients with free fluid were observed for a mean of 8 days (95% confidence interval 6.1 to 10.4, range 1 to 131). There were no missed injuries.
Conclusions: Free fluid on abdominal CT scan does not mandate celiotomy. Serial observation with the possible use of other adjunctive tests is recommended.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11532406</pmid><doi>10.1016/S0002-9610(01)00665-1</doi><tpages>4</tpages></addata></record> |
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| subjects | Abdomen Abdominal Injuries - diagnosis Abdominal Injuries - diagnostic imaging Abdominal Injuries - surgery Adult Biological and medical sciences Blunt abdominal injury Body Fluids - diagnostic imaging Celiotomy Computed tomography Contusions Emergency medical care Female Free fluid Hollow viscus injury Humans Injuries Injuries of the abdomen. Foreign bodies of the digestive system Intestine Intestines - injuries Laparotomy Male Medical imaging Medical sciences Morbidity Patients Predictive Value of Tests Prospective Studies Reading Sensitivity and Specificity Solid organ injury Tomography Tomography, X-Ray Computed Trauma Traumas. Diseases due to physical agents Wounds, Nonpenetrating - diagnosis Wounds, Nonpenetrating - diagnostic imaging Wounds, Nonpenetrating - surgery |
| title | Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy |
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