The role of computerized tomography in penetrating abdominal trauma
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Colégio Brasileiro de Cirurgiões |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000100159 |
Resumo: | ABSTRACT Objective: to evaluate the role of abdominal computed tomography in the management of penetrating abdominal trauma. Methods: we conducted a historical cohort study of patients treated for penetrating trauma in the anterior abdomen, dorsum or thoracoabdominal transition, that were submitted to a computed tomography carried out on admission. We evaluated the location of the wound and the presence of tomographic findings, and the management of these patients as for nonoperative treatment or laparotomy. We calculated the sensitivity and specificity of computed tomography according to the evolution of the nonoperative treatment or the surgical findings. Results: we selected 61 patients, 31 with trauma to the anterior abdomen and 30 to the dorsum or thoracoabdominal transition. The mortality rate was 6.5% (n=4), all in the late postoperative period. Eleven patients with trauma to the anterior abdomen were submitted to nonoperative treatment, and 20, to laparotomy. Of the 30 patients with trauma to the dorsum or thoracoabdominal transition, 23 underwent nonoperative treatment and seven, laparotomy. There were three nonoperative treatment failures. In penetrating trauma of the anterior abdomen, the sensitivity of computed tomography was 94.1% and the negative predictive value was 93.3%. In dorsal or thoracoabdominal transition lesions, the sensitivity was 90% and the negative predictive value was 95.5%. In both groups, the specificity and the positive predictive value were 100%. Conclusion: the accuracy of computed tomography was adequate to guide the management of stable patients who could be treated conservatively, avoiding mandatory surgery in 34 patients and reducing the morbidity and mortality of non-therapeutic laparotomies. |
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The role of computerized tomography in penetrating abdominal traumaTomographyAbdominal InjuriesSensitivity and SpecificityConservative TreatmentMultiple TraumaABSTRACT Objective: to evaluate the role of abdominal computed tomography in the management of penetrating abdominal trauma. Methods: we conducted a historical cohort study of patients treated for penetrating trauma in the anterior abdomen, dorsum or thoracoabdominal transition, that were submitted to a computed tomography carried out on admission. We evaluated the location of the wound and the presence of tomographic findings, and the management of these patients as for nonoperative treatment or laparotomy. We calculated the sensitivity and specificity of computed tomography according to the evolution of the nonoperative treatment or the surgical findings. Results: we selected 61 patients, 31 with trauma to the anterior abdomen and 30 to the dorsum or thoracoabdominal transition. The mortality rate was 6.5% (n=4), all in the late postoperative period. Eleven patients with trauma to the anterior abdomen were submitted to nonoperative treatment, and 20, to laparotomy. Of the 30 patients with trauma to the dorsum or thoracoabdominal transition, 23 underwent nonoperative treatment and seven, laparotomy. There were three nonoperative treatment failures. In penetrating trauma of the anterior abdomen, the sensitivity of computed tomography was 94.1% and the negative predictive value was 93.3%. In dorsal or thoracoabdominal transition lesions, the sensitivity was 90% and the negative predictive value was 95.5%. In both groups, the specificity and the positive predictive value were 100%. Conclusion: the accuracy of computed tomography was adequate to guide the management of stable patients who could be treated conservatively, avoiding mandatory surgery in 34 patients and reducing the morbidity and mortality of non-therapeutic laparotomies.Colégio Brasileiro de Cirurgiões2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000100159Revista do Colégio Brasileiro de Cirurgiões v.45 n.1 2018reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-6991e-20181348info:eu-repo/semantics/openAccessMARTINS FILHO,EDUARDO LOPESMAZEPA,MELISSA MELLOGUETTER,CAMILA ROGINSKIPIMENTEL,SILVÂNIA KLUGeng2018-02-15T00:00:00Zoai:scielo:S0100-69912018000100159Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2018-02-15T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false |
dc.title.none.fl_str_mv |
The role of computerized tomography in penetrating abdominal trauma |
title |
The role of computerized tomography in penetrating abdominal trauma |
spellingShingle |
The role of computerized tomography in penetrating abdominal trauma MARTINS FILHO,EDUARDO LOPES Tomography Abdominal Injuries Sensitivity and Specificity Conservative Treatment Multiple Trauma |
title_short |
The role of computerized tomography in penetrating abdominal trauma |
title_full |
The role of computerized tomography in penetrating abdominal trauma |
title_fullStr |
The role of computerized tomography in penetrating abdominal trauma |
title_full_unstemmed |
The role of computerized tomography in penetrating abdominal trauma |
title_sort |
The role of computerized tomography in penetrating abdominal trauma |
author |
MARTINS FILHO,EDUARDO LOPES |
author_facet |
MARTINS FILHO,EDUARDO LOPES MAZEPA,MELISSA MELLO GUETTER,CAMILA ROGINSKI PIMENTEL,SILVÂNIA KLUG |
author_role |
author |
author2 |
MAZEPA,MELISSA MELLO GUETTER,CAMILA ROGINSKI PIMENTEL,SILVÂNIA KLUG |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
MARTINS FILHO,EDUARDO LOPES MAZEPA,MELISSA MELLO GUETTER,CAMILA ROGINSKI PIMENTEL,SILVÂNIA KLUG |
dc.subject.por.fl_str_mv |
Tomography Abdominal Injuries Sensitivity and Specificity Conservative Treatment Multiple Trauma |
topic |
Tomography Abdominal Injuries Sensitivity and Specificity Conservative Treatment Multiple Trauma |
description |
ABSTRACT Objective: to evaluate the role of abdominal computed tomography in the management of penetrating abdominal trauma. Methods: we conducted a historical cohort study of patients treated for penetrating trauma in the anterior abdomen, dorsum or thoracoabdominal transition, that were submitted to a computed tomography carried out on admission. We evaluated the location of the wound and the presence of tomographic findings, and the management of these patients as for nonoperative treatment or laparotomy. We calculated the sensitivity and specificity of computed tomography according to the evolution of the nonoperative treatment or the surgical findings. Results: we selected 61 patients, 31 with trauma to the anterior abdomen and 30 to the dorsum or thoracoabdominal transition. The mortality rate was 6.5% (n=4), all in the late postoperative period. Eleven patients with trauma to the anterior abdomen were submitted to nonoperative treatment, and 20, to laparotomy. Of the 30 patients with trauma to the dorsum or thoracoabdominal transition, 23 underwent nonoperative treatment and seven, laparotomy. There were three nonoperative treatment failures. In penetrating trauma of the anterior abdomen, the sensitivity of computed tomography was 94.1% and the negative predictive value was 93.3%. In dorsal or thoracoabdominal transition lesions, the sensitivity was 90% and the negative predictive value was 95.5%. In both groups, the specificity and the positive predictive value were 100%. Conclusion: the accuracy of computed tomography was adequate to guide the management of stable patients who could be treated conservatively, avoiding mandatory surgery in 34 patients and reducing the morbidity and mortality of non-therapeutic laparotomies. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000100159 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000100159 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-6991e-20181348 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões v.45 n.1 2018 reponame:Revista do Colégio Brasileiro de Cirurgiões instname:Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC |
instname_str |
Colégio Brasileiro de Cirurgiões (CBC) |
instacron_str |
CBC |
institution |
CBC |
reponame_str |
Revista do Colégio Brasileiro de Cirurgiões |
collection |
Revista do Colégio Brasileiro de Cirurgiões |
repository.name.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC) |
repository.mail.fl_str_mv |
||revistacbc@cbc.org.br |
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1754209214093328384 |