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Erschienen in:
16.03.2016 | Emergency Radiology
Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study
Erschienen in: European Radiology | Ausgabe 11/2016
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Purpose
Neither the performance of CT in diagnosing penetrating gastrointestinal injury nor its ability to discriminate patients requiring either observation or surgery has been determined.
Materials and methods
This was a prospective, single-institutional observational study of patients with penetrating injury to the torso who underwent CT. Based on CT signs, reviewers determined the presence of a gastrointestinal injury and the need for surgery or observation. The primary outcome measures were operative findings and clinical follow-up. CT results were compared with the primary outcome measures.
Results
Of one hundred and seventy-one patients (72 gunshot wounds, 99 stab wounds; age range, 18–57 years; median age, 28 years) with penetrating torso trauma who underwent CT, 45 % were followed by an operation and 55 % by clinical follow up. Thirty-five patients had a gastrointestinal injury at surgery. The sensitivity, specificity, and accuracy of CT for diagnosing a gastrointestinal injury for all patients were each 91 %, and for predicting the need for surgery, they were 94 %, 93 %, 93 %, respectively. Among the 3 % of patients who failed observation, 1 % had a gastrointestinal injury.
Conclusion
CT is a useful technique to diagnose gastrointestinal injury following penetrating torso injury. CT can help discriminate patients requiring observation or surgery.
Key Points
• The most sensitive sign is wound tract extending up to gastrointestinal wall.
• The most accurate sign is gastrointestinal wall thickening.
• Triple-contrast CT is a useful technique to diagnose gastrointestinal injury.
• Triple-contrast CT helps to discriminate patients requiring observation and surgery.