The role of computed tomography in selective management of gunshot wounds to the abdomen and flank.
J Trauma
; 45(6): 1005-9, 1998 Dec.
Article
em En
| MEDLINE
| ID: mdl-9867040
ABSTRACT
OBJECTIVE:
To determine whether computed tomography (CT) is an accurate diagnostic modality for the triage of hemodynamically stable patients with gunshot wounds of the abdomen and flank.METHODS:
A chart review of 83 trauma patients for whom abdominal CT was used as initial screening.RESULTS:
In 53 patients, CT revealed no evidence of peritoneal penetration, and in 15 patients, there was evidence of either peritoneal penetration or liver injury. There were no false results in these patients. Among 15 patients with questionable peritoneal penetration, cavitary endoscopy was performed in 11 and exploratory laparotomy was performed in 3, and 1 patient was initially observed and subsequently underwent exploratory surgery for a missed colonic injury.CONCLUSION:
In selected centers and in hemodynamically stable patients with abdominal and flank gunshot wounds, abdominal CT can be an effective and safe initial screening modality to document the presence or absence of peritoneal penetration and to manage nonoperatively stable patients with liver injuries. If there is any question of peritoneal penetration, cavitary endoscopy should be part of the protocol of nonoperative management.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Peritônio
/
Ferimentos por Arma de Fogo
/
Tomografia Computadorizada por Raios X
/
Traumatismos Abdominais
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Trauma
Ano de publicação:
1998
Tipo de documento:
Article