Performance of helical computed tomography without oral contrast for the detection of gastrointestinal injuries
We describe the performance of helical abdominal computed tomography (CT) scan without oral contrast for the detection of blunt gastrointestinal injuries. We retrospectively reviewed the records of a consecutive series of patients who underwent helical abdominal CT scanning for evaluation of blunt i...
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| Veröffentlicht in: | Annals of emergency medicine 2004, Vol.43 (1), p.120-128 |
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| container_title | Annals of emergency medicine |
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| creator | Holmes, James F. Offerman, Steven R. Chang, Cindy H. Randel, Brad E. Hahn, David D. Frankovsky, Matthew J. Wisner, David H. |
| description | We describe the performance of helical abdominal computed tomography (CT) scan without oral contrast for the detection of blunt gastrointestinal injuries.
We retrospectively reviewed the records of a consecutive series of patients who underwent helical abdominal CT scanning for evaluation of blunt intra-abdominal injury and were admitted to a Level I trauma center from May 1996 to September 2001. Abdominal CT scans were performed with intravenous contrast but without oral contrast. Patients were considered to have gastrointestinal injuries if an injury was identified to the gastrointestinal tract from the duodenum to the sigmoid colon or associated mesentery and considered to have major gastrointestinal injuries if gastrointestinal perforation, active mesenteric hemorrhage, or mesenteric devascularization occurred. All gastrointestinal injuries were confirmed by laparotomy, autopsy, or additional imaging studies.
Six thousand fifty-two patients underwent abdominal CT scan (mean age 35.5 ± 21.1 years), and 106 (1.8%) patients had gastrointestinal injuries identified by laparotomy, autopsy, or additional (nonabdominal CT) imaging studies. Abdominal CT scan result was abnormal in 91 (86%; 95% confidence interval [CI] 78% to 92%) of the 106 patients with gastrointestinal injuries and revealed findings suggestive of gastrointestinal injury in 81 (76%; 95% CI 67% to 84%) patients. Abdominal CT scan demonstrated findings suggestive of gastrointestinal injury in 58 of 64 (91%; 95% CI 81% to 96%) patients with major gastrointestinal injuries. Two hundred thirty-eight (4.0%) patients had findings suspicious for gastrointestinal injuries on abdominal CT scan, but gastrointestinal injury was never confirmed.
Helical abdominal CT scan without oral contrast identified nearly three fourths of patients with blunt gastrointestinal injuries who were selected for abdominal CT scanning. Sensitivity of this diagnostic test improves in the subset of patients with major gastrointestinal injuries.
[
Ann Emerg Med. 2004;43:120-128.] |
| doi_str_mv | 10.1016/S0196-0644(03)00727-3 |
| format | Article |
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We retrospectively reviewed the records of a consecutive series of patients who underwent helical abdominal CT scanning for evaluation of blunt intra-abdominal injury and were admitted to a Level I trauma center from May 1996 to September 2001. Abdominal CT scans were performed with intravenous contrast but without oral contrast. Patients were considered to have gastrointestinal injuries if an injury was identified to the gastrointestinal tract from the duodenum to the sigmoid colon or associated mesentery and considered to have major gastrointestinal injuries if gastrointestinal perforation, active mesenteric hemorrhage, or mesenteric devascularization occurred. All gastrointestinal injuries were confirmed by laparotomy, autopsy, or additional imaging studies.
Six thousand fifty-two patients underwent abdominal CT scan (mean age 35.5 ± 21.1 years), and 106 (1.8%) patients had gastrointestinal injuries identified by laparotomy, autopsy, or additional (nonabdominal CT) imaging studies. Abdominal CT scan result was abnormal in 91 (86%; 95% confidence interval [CI] 78% to 92%) of the 106 patients with gastrointestinal injuries and revealed findings suggestive of gastrointestinal injury in 81 (76%; 95% CI 67% to 84%) patients. Abdominal CT scan demonstrated findings suggestive of gastrointestinal injury in 58 of 64 (91%; 95% CI 81% to 96%) patients with major gastrointestinal injuries. Two hundred thirty-eight (4.0%) patients had findings suspicious for gastrointestinal injuries on abdominal CT scan, but gastrointestinal injury was never confirmed.
Helical abdominal CT scan without oral contrast identified nearly three fourths of patients with blunt gastrointestinal injuries who were selected for abdominal CT scanning. Sensitivity of this diagnostic test improves in the subset of patients with major gastrointestinal injuries.
[
Ann Emerg Med. 2004;43:120-128.]</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/S0196-0644(03)00727-3</identifier><identifier>PMID: 14707951</identifier><identifier>CODEN: AEMED3</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject><![CDATA[Adolescent ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Child ; Child, Preschool ; Contrast Media - administration & dosage ; Digestive System - injuries ; Emergency Service, Hospital - statistics & numerical data ; Female ; Humans ; Infant ; Intensive care medicine ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Radiography, Abdominal - methods ; Radiography, Abdominal - statistics & numerical data ; Registries - statistics & numerical data ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed - methods ; Tomography, Spiral Computed - statistics & numerical data ; Trauma Centers - statistics & numerical data ; Wounds and Injuries - diagnostic imaging ; Wounds, Nonpenetrating - diagnostic imaging]]></subject><ispartof>Annals of emergency medicine, 2004, Vol.43 (1), p.120-128</ispartof><rights>2004 American College of Emergency Physicians</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-e372b5aa5a344a189995f6a3ca6cbf6287c7b9c442c9bd53223eed9d16ccbe2f3</citedby><cites>FETCH-LOGICAL-c391t-e372b5aa5a344a189995f6a3ca6cbf6287c7b9c442c9bd53223eed9d16ccbe2f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196064403007273$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27902,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15574424$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14707951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holmes, James F.</creatorcontrib><creatorcontrib>Offerman, Steven R.</creatorcontrib><creatorcontrib>Chang, Cindy H.</creatorcontrib><creatorcontrib>Randel, Brad E.</creatorcontrib><creatorcontrib>Hahn, David D.</creatorcontrib><creatorcontrib>Frankovsky, Matthew J.</creatorcontrib><creatorcontrib>Wisner, David H.</creatorcontrib><title>Performance of helical computed tomography without oral contrast for the detection of gastrointestinal injuries</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>We describe the performance of helical abdominal computed tomography (CT) scan without oral contrast for the detection of blunt gastrointestinal injuries.
We retrospectively reviewed the records of a consecutive series of patients who underwent helical abdominal CT scanning for evaluation of blunt intra-abdominal injury and were admitted to a Level I trauma center from May 1996 to September 2001. Abdominal CT scans were performed with intravenous contrast but without oral contrast. Patients were considered to have gastrointestinal injuries if an injury was identified to the gastrointestinal tract from the duodenum to the sigmoid colon or associated mesentery and considered to have major gastrointestinal injuries if gastrointestinal perforation, active mesenteric hemorrhage, or mesenteric devascularization occurred. All gastrointestinal injuries were confirmed by laparotomy, autopsy, or additional imaging studies.
Six thousand fifty-two patients underwent abdominal CT scan (mean age 35.5 ± 21.1 years), and 106 (1.8%) patients had gastrointestinal injuries identified by laparotomy, autopsy, or additional (nonabdominal CT) imaging studies. Abdominal CT scan result was abnormal in 91 (86%; 95% confidence interval [CI] 78% to 92%) of the 106 patients with gastrointestinal injuries and revealed findings suggestive of gastrointestinal injury in 81 (76%; 95% CI 67% to 84%) patients. Abdominal CT scan demonstrated findings suggestive of gastrointestinal injury in 58 of 64 (91%; 95% CI 81% to 96%) patients with major gastrointestinal injuries. Two hundred thirty-eight (4.0%) patients had findings suspicious for gastrointestinal injuries on abdominal CT scan, but gastrointestinal injury was never confirmed.
Helical abdominal CT scan without oral contrast identified nearly three fourths of patients with blunt gastrointestinal injuries who were selected for abdominal CT scanning. Sensitivity of this diagnostic test improves in the subset of patients with major gastrointestinal injuries.
[
Ann Emerg Med. 2004;43:120-128.]</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Contrast Media - administration & dosage</subject><subject>Digestive System - injuries</subject><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Radiography, Abdominal - methods</subject><subject>Radiography, Abdominal - statistics & numerical data</subject><subject>Registries - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, Spiral Computed - methods</subject><subject>Tomography, Spiral Computed - statistics & numerical data</subject><subject>Trauma Centers - statistics & numerical data</subject><subject>Wounds and Injuries - diagnostic imaging</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1PFTEUhhuDkQv6EzTdQGAx2u9OV4QQQRMSTdR10-mc4ZbMTK9tB8O_t_cjsnR1Fn3ec948Reg9JR8poerTD0KNaogS4oLwS0I00w1_hVaUGN0orcgRWv1DjtFJzo-EECMYfYOOqdBEG0lXKH6HNMQ0udkDjgNewxi8G7GP02Yp0OMSp_iQ3Gb9jP-Eso5LwTHtgLkklwuuaVzWgHso4EuI83bNQ31JMcwFcglzxcP8uKQA-S16Pbgxw7vDPEW_bj__vPnS3H-7-3pzfd94bmhpgGvWSeek40I42hpj5KAc9075blCs1V53xgvBvOl6yRnjAL3pqfK-AzbwU3S-37tJ8fdSW9gpZA_j6GaIS7YtIS0Tsq2g3IM-xZwTDHaTwuTSs6XEbk3bnWm71WgJtzvTltfch8OBpZugf0kd1Fbg7AC4XI0OqSoO-YWTUtf6onJXew6qjqcAyWYfoH5HH1IVavsY_lPlL6BPndU</recordid><startdate>2004</startdate><enddate>2004</enddate><creator>Holmes, James F.</creator><creator>Offerman, Steven R.</creator><creator>Chang, Cindy H.</creator><creator>Randel, Brad E.</creator><creator>Hahn, David D.</creator><creator>Frankovsky, Matthew J.</creator><creator>Wisner, David H.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2004</creationdate><title>Performance of helical computed tomography without oral contrast for the detection of gastrointestinal injuries</title><author>Holmes, James F. ; Offerman, Steven R. ; Chang, Cindy H. ; Randel, Brad E. ; Hahn, David D. ; Frankovsky, Matthew J. ; Wisner, David H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-e372b5aa5a344a189995f6a3ca6cbf6287c7b9c442c9bd53223eed9d16ccbe2f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Contrast Media - administration & dosage</topic><topic>Digestive System - injuries</topic><topic>Emergency Service, Hospital - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Radiography, Abdominal - methods</topic><topic>Radiography, Abdominal - statistics & numerical data</topic><topic>Registries - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, Spiral Computed - methods</topic><topic>Tomography, Spiral Computed - statistics & numerical data</topic><topic>Trauma Centers - statistics & numerical data</topic><topic>Wounds and Injuries - diagnostic imaging</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holmes, James F.</creatorcontrib><creatorcontrib>Offerman, Steven R.</creatorcontrib><creatorcontrib>Chang, Cindy H.</creatorcontrib><creatorcontrib>Randel, Brad E.</creatorcontrib><creatorcontrib>Hahn, David D.</creatorcontrib><creatorcontrib>Frankovsky, Matthew J.</creatorcontrib><creatorcontrib>Wisner, David H.</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>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holmes, James F.</au><au>Offerman, Steven R.</au><au>Chang, Cindy H.</au><au>Randel, Brad E.</au><au>Hahn, David D.</au><au>Frankovsky, Matthew J.</au><au>Wisner, David H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of helical computed tomography without oral contrast for the detection of gastrointestinal injuries</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>2004</date><risdate>2004</risdate><volume>43</volume><issue>1</issue><spage>120</spage><epage>128</epage><pages>120-128</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><coden>AEMED3</coden><abstract>We describe the performance of helical abdominal computed tomography (CT) scan without oral contrast for the detection of blunt gastrointestinal injuries.
We retrospectively reviewed the records of a consecutive series of patients who underwent helical abdominal CT scanning for evaluation of blunt intra-abdominal injury and were admitted to a Level I trauma center from May 1996 to September 2001. Abdominal CT scans were performed with intravenous contrast but without oral contrast. Patients were considered to have gastrointestinal injuries if an injury was identified to the gastrointestinal tract from the duodenum to the sigmoid colon or associated mesentery and considered to have major gastrointestinal injuries if gastrointestinal perforation, active mesenteric hemorrhage, or mesenteric devascularization occurred. All gastrointestinal injuries were confirmed by laparotomy, autopsy, or additional imaging studies.
Six thousand fifty-two patients underwent abdominal CT scan (mean age 35.5 ± 21.1 years), and 106 (1.8%) patients had gastrointestinal injuries identified by laparotomy, autopsy, or additional (nonabdominal CT) imaging studies. Abdominal CT scan result was abnormal in 91 (86%; 95% confidence interval [CI] 78% to 92%) of the 106 patients with gastrointestinal injuries and revealed findings suggestive of gastrointestinal injury in 81 (76%; 95% CI 67% to 84%) patients. Abdominal CT scan demonstrated findings suggestive of gastrointestinal injury in 58 of 64 (91%; 95% CI 81% to 96%) patients with major gastrointestinal injuries. Two hundred thirty-eight (4.0%) patients had findings suspicious for gastrointestinal injuries on abdominal CT scan, but gastrointestinal injury was never confirmed.
Helical abdominal CT scan without oral contrast identified nearly three fourths of patients with blunt gastrointestinal injuries who were selected for abdominal CT scanning. Sensitivity of this diagnostic test improves in the subset of patients with major gastrointestinal injuries.
[
Ann Emerg Med. 2004;43:120-128.]</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>14707951</pmid><doi>10.1016/S0196-0644(03)00727-3</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0196-0644 |
| ispartof | Annals of emergency medicine, 2004, Vol.43 (1), p.120-128 |
| issn | 0196-0644 1097-6760 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Child Child, Preschool Contrast Media - administration & dosage Digestive System - injuries Emergency Service, Hospital - statistics & numerical data Female Humans Infant Intensive care medicine Male Medical sciences Middle Aged Predictive Value of Tests Radiography, Abdominal - methods Radiography, Abdominal - statistics & numerical data Registries - statistics & numerical data Retrospective Studies Sensitivity and Specificity Tomography, Spiral Computed - methods Tomography, Spiral Computed - statistics & numerical data Trauma Centers - statistics & numerical data Wounds and Injuries - diagnostic imaging Wounds, Nonpenetrating - diagnostic imaging |
| title | Performance of helical computed tomography without oral contrast for the detection of gastrointestinal injuries |
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