RESUMEN
BACKGROUND: Computed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. METHODS: The study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. RESULTS: Of the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). CONCLUSIONS: The hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.
Asunto(s)
Traumatismos Abdominales , Heridas no Penetrantes , Traumatismos Abdominales/diagnóstico por imagen , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnósticoRESUMEN
Cases of diverticulosis of the colon continue to increase, especially in the Western countries. In these countries, two-thirds of the population older than 70 years of age are considered to experience this disease. Medical and surgical treatment for diverticulosis actually begun for the complications of diverticulitis and lower gastrointestinal hemorrhage. The first evaluation of complicated diverticular disease is based on patient's history, physical examination, and laboratory data. But all these exams and data can be inaccurate and are often questionable in the diagnoses of many features of the disease. To describe the position, severity, and presence of complications of a detected diverticulum is crucial to its appropriate treatment. The greater part of the patients have mild disease and can be successfully cured medically. Only a small number of patients admit with acute diverticulitis and need urgent surgical intervention. Determining these patients early is crucial to morbidity and mortality reduction. Radiologic examination is important for exact evaluation of the extent of the course of the disease over the last three decades. This article aims to chart the place of the Computed Tomography (CT) imaging procedure in the assessment of acute complicated diverticular disease.