Document Detail


The prevalence of incidental findings on abdominal computed tomography scans of trauma patients.
MedLine Citation:
PMID:  19232878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Abdominal computed tomography scanning (AbdCTS) is the standard of care in the evaluation of blunt trauma patients. The liberal use of AbdCTS coupled with advancing imaging technology often results in the detection of incidental findings. OBJECTIVES: We sought to characterize the incidence and prevalence of such findings, describe the lesions most frequently seen on AbdCTS performed on patients admitted to a Level I trauma center, and develop a plan for follow-up through our performance improvement process. METHODS: AbdCTS reports of all admissions to a Level I trauma center between January 2000 and December 2002 were reviewed. Incidental findings identified were classified into benign anatomic variants, benign pathologic lesions, and pathologic lesions requiring further work-up. RESULTS: A total of 3,113 patients were evaluated by AbdCTS during this time period. There were 1474 incidental findings in 1,103 patients. Seventy-five percent of patients with incidental lesions had no traumatic findings. Benign anatomic variants were present in 1.8%, benign pathologic findings in 27.5%, and pathologic findings requiring work-up in 6.1%. Congenital renal anomalies and duplicate inferior vena cava were the most common benign anatomical findings. Renal and hepatic cysts were the most frequent benign lesions and non-calcified pulmonary nodules and adrenal masses were the pathologic lesions most commonly seen. CONCLUSIONS: Incidental findings are seen in up to 35% of trauma AbdCTS. No concomitant traumatic injuries are present in up to 75% of these patients. Protocols for appropriate intervention or arrangements for follow-up care need to be incorporated into the care of the trauma patients.
Authors:
Akpofure Peter Ekeh; Mbaga Walusimbi; Erin Brigham; Randy J Woods; Mary C McCarthy
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Publication Detail:
Type:  Journal Article     Date:  2009-02-20
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  38     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  484-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Wright State University, Dayton, Ohio 45459, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Injuries / radiography*
Emergency Service, Hospital*
Humans
Incidental Findings*
Male
Ohio / epidemiology
Prevalence
Retrospective Studies
Tomography, X-Ray Computed*
Trauma Centers / statistics & numerical data
Wounds, Nonpenetrating / radiography*

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