Computed tomography in blunt hepatic trauma

Archives of Surgery
K A DavisW G Cioffi

Abstract

Nonoperative management of blunt hepatic injury in hemodynamically stable trauma patients is now common. Recently, it has been proposed that the finding of hepatic periportal tracking (PPT) of blood on the initial computed tomographic (CT) scan is a sensitive marker of significant hepatic and subhepatic injury that might militate against nonoperative management. While CT scan is useful in diagnosing the injury, the utility of follow-up CT scans has not been elucidated. Retrospective chart review. Regional trauma center. The records of 58 hemodynamically stable patients with blunt hepatic trauma were reviewed and the following data recorded: age, outcome, Injury Severity Score (ISS), operative intervention, and complications. Computed tomographic scans were taken on admission and reviewed for the presence of PPT. The timing and radiographic appearance of follow-up CT scans was also recorded. Seventeen patients (29%) had radiographic evidence of PPT while 41 patients (71%) did not. Age, ISS, injury grade, overall success rate of nonoperative management, and incidence of complications were not statistically significant between the two groups. In no instance did a routine follow-up CT scan affect subsequent management of the patien...Continue Reading

Citations

Sep 18, 2009·World Journal of Surgery·S A BadgerT Diamond
Sep 17, 2009·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M LossH J Schlitt
Sep 2, 2006·Journal of Intensive Care Medicine·Deborah M Stein, Thomas M Scalea
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Sep 3, 1999·The Australian and New Zealand Journal of Surgery·R W Strong
Jun 30, 2007·Current Opinion in Critical Care·Thomas J Schroeppel, Martin A Croce
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Feb 14, 2012·The Journal of Trauma and Acute Care Surgery·H Leon Pachter
Jan 24, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Khadidja Malloum BoukarJulien Clement

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