| Contrast material extravasation on contrast-enhanced helical computed tomographic scan of blunt abdominal trauma: its significance on the choice, time, and outcome of treatment. | |
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MedLine Citation:
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PMID: 12544913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Contrast-enhanced helical computed tomographic (CT) scan of blunt abdominal trauma is valuable for detecting contrast material extravasation (CME). The aims of this study were to determine its significance and investigate factors associated with the choice, time, and outcome of management. METHODS: CT scans of 32 consecutive trauma patients who had CME were reviewed for the sources of CME, types of CME, flat inferior vena cava, and multiple abdominal injuries. The medical records were reviewed for demographics, systolic blood pressure, Injury Severity Score (ISS), choice of management, time interval between CT scan and intervention, and outcome of intervention. RESULTS: Systolic blood pressure < 100 mm Hg was the most important factor (p = 0.0064) that failed observational therapy. When proceeding to intervention treatment, patients with a flat inferior vena cava (1.6 +/- 1.1 hours) had a significantly shorter time interval between CT scan examination and intervention when compared with those with a normal cava (10.9 +/- 16.0 hours) ( p= 0.0124). The mortality rate after intervention treatment was 18.8%. High ISS, uncontained CME in the extraperitoneum, and multiple abdominal injuries were important risk factors. After adjusted for ISS and multiple abdominal injuries, the risk of dying from extraperitoneal CME remained significant when compared with intraperitoneal CME (adjusted odds ratio, 82.26; 95% confidence interval, 1.06-6,363.17). CONCLUSION: Termination of observational therapy was appropriate for trauma patients who had CME and systolic blood pressure < 100 mm Hg. The coexistence of a flat inferior vena cava and CME was associated with early intervention treatment. Despite early intervention, the mortality rate was 18.8%. High ISS and multiple abdominal injuries were important factors, but the risk of dying from uncontained extraperitoneal CME was 82 times the risk of dying from intraperitoneal CME. |
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Authors:
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Yon-Cheong Wong; Li-Jen Wang; Lai-Chu See; Jen-Feng Fang; Chip-Jin Ng; Chi-Jen Chen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 54 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-01-24 Completed Date: 2003-02-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 164-70 Citation Subset: AIM; IM |
Affiliation:
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Second Division, Department of Radiology, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Gueishan, Taoyuan 33333, Taiwan. ycwong@cgmh.org.tw |
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Injuries
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classification,
radiography* Adolescent Adult Analysis of Variance Cause of Death Child Child, Preschool Extravasation of Diagnostic and Therapeutic Materials / diagnosis, etiology*, mortality, therapy* Female Humans Injury Severity Score Logistic Models Male Middle Aged Patient Selection Peritoneal Diseases / etiology Retrospective Studies Risk Factors Time Factors Tomography, X-Ray Computed / adverse effects*, methods Trauma Centers Treatment Outcome Wounds, Nonpenetrating / classification, radiography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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