Computed tomography in the evaluation of children with blunt abdominal trauma

Dan M. Meyer, Erwin R. Thal, Dale Coln, John A. Weigelt

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: This study determined the sensitivity, specificity, and accuracy of CT in pediatric patients with blunt trauma. Correlation of the CT-identified injuries and intraoperative findings with comparison to the results of DPL was performed. Summary Background Data: Clinical evaluation frequently is unreliable in determining the presence of intra-abdominal injury in children with blunt trauma. Peritoneal lavage has been used to establish the need for operative intervention and has been found to be safe, efficient, and reliable (98%). In many institutions, abdominal CT scans are used to evaluate these children. Because most reports involve nonoperative management, operative confirmation of CT-identified injuries is available only for those children in whom nonoperative treatment is unsuccessful. Methods: Sixty children sustaining blunt abdominal trauma were included in the study. CT scans with both oral and IV contrast were performed before open lavage, and positive results were confirmed by operation in 18 patients. Results: CT had a sensitivity of 67%, however, only 60% of the actual organ injuries were identified by the scan. In contrast, DPL has a sensitivity of 94%. Both studies were equally specific (100%). DPL was also more accurate, 98% as compared with 89% for CT. Conclusions: Although the abdominal CT scan is useful in evaluating children with blunt abdominal trauma, a number of significant injuries were missed. Based on the low sensitivity of the CT, the authors suggest diagnostic peritoneal lavage may offer advantages over CT as the initial study in the evaluation of children with blunt abdominal trauma.

Original languageEnglish (US)
Pages (from-to)272-276
Number of pages5
JournalAnnals of Surgery
Volume217
Issue number3
StatePublished - Mar 1993

Fingerprint

Tomography
Wounds and Injuries
Peritoneal Lavage
Abdominal Injuries
Therapeutic Irrigation
Pediatrics
Sensitivity and Specificity

ASJC Scopus subject areas

  • Surgery

Cite this

Meyer, D. M., Thal, E. R., Coln, D., & Weigelt, J. A. (1993). Computed tomography in the evaluation of children with blunt abdominal trauma. Annals of Surgery, 217(3), 272-276.

Computed tomography in the evaluation of children with blunt abdominal trauma. / Meyer, Dan M.; Thal, Erwin R.; Coln, Dale; Weigelt, John A.

In: Annals of Surgery, Vol. 217, No. 3, 03.1993, p. 272-276.

Research output: Contribution to journalArticle

Meyer, DM, Thal, ER, Coln, D & Weigelt, JA 1993, 'Computed tomography in the evaluation of children with blunt abdominal trauma', Annals of Surgery, vol. 217, no. 3, pp. 272-276.
Meyer, Dan M. ; Thal, Erwin R. ; Coln, Dale ; Weigelt, John A. / Computed tomography in the evaluation of children with blunt abdominal trauma. In: Annals of Surgery. 1993 ; Vol. 217, No. 3. pp. 272-276.
@article{283ffadb016549779ac2d37210ff3ce6,
title = "Computed tomography in the evaluation of children with blunt abdominal trauma",
abstract = "Objective: This study determined the sensitivity, specificity, and accuracy of CT in pediatric patients with blunt trauma. Correlation of the CT-identified injuries and intraoperative findings with comparison to the results of DPL was performed. Summary Background Data: Clinical evaluation frequently is unreliable in determining the presence of intra-abdominal injury in children with blunt trauma. Peritoneal lavage has been used to establish the need for operative intervention and has been found to be safe, efficient, and reliable (98{\%}). In many institutions, abdominal CT scans are used to evaluate these children. Because most reports involve nonoperative management, operative confirmation of CT-identified injuries is available only for those children in whom nonoperative treatment is unsuccessful. Methods: Sixty children sustaining blunt abdominal trauma were included in the study. CT scans with both oral and IV contrast were performed before open lavage, and positive results were confirmed by operation in 18 patients. Results: CT had a sensitivity of 67{\%}, however, only 60{\%} of the actual organ injuries were identified by the scan. In contrast, DPL has a sensitivity of 94{\%}. Both studies were equally specific (100{\%}). DPL was also more accurate, 98{\%} as compared with 89{\%} for CT. Conclusions: Although the abdominal CT scan is useful in evaluating children with blunt abdominal trauma, a number of significant injuries were missed. Based on the low sensitivity of the CT, the authors suggest diagnostic peritoneal lavage may offer advantages over CT as the initial study in the evaluation of children with blunt abdominal trauma.",
author = "Meyer, {Dan M.} and Thal, {Erwin R.} and Dale Coln and Weigelt, {John A.}",
year = "1993",
month = "3",
language = "English (US)",
volume = "217",
pages = "272--276",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Computed tomography in the evaluation of children with blunt abdominal trauma

AU - Meyer, Dan M.

AU - Thal, Erwin R.

AU - Coln, Dale

AU - Weigelt, John A.

PY - 1993/3

Y1 - 1993/3

N2 - Objective: This study determined the sensitivity, specificity, and accuracy of CT in pediatric patients with blunt trauma. Correlation of the CT-identified injuries and intraoperative findings with comparison to the results of DPL was performed. Summary Background Data: Clinical evaluation frequently is unreliable in determining the presence of intra-abdominal injury in children with blunt trauma. Peritoneal lavage has been used to establish the need for operative intervention and has been found to be safe, efficient, and reliable (98%). In many institutions, abdominal CT scans are used to evaluate these children. Because most reports involve nonoperative management, operative confirmation of CT-identified injuries is available only for those children in whom nonoperative treatment is unsuccessful. Methods: Sixty children sustaining blunt abdominal trauma were included in the study. CT scans with both oral and IV contrast were performed before open lavage, and positive results were confirmed by operation in 18 patients. Results: CT had a sensitivity of 67%, however, only 60% of the actual organ injuries were identified by the scan. In contrast, DPL has a sensitivity of 94%. Both studies were equally specific (100%). DPL was also more accurate, 98% as compared with 89% for CT. Conclusions: Although the abdominal CT scan is useful in evaluating children with blunt abdominal trauma, a number of significant injuries were missed. Based on the low sensitivity of the CT, the authors suggest diagnostic peritoneal lavage may offer advantages over CT as the initial study in the evaluation of children with blunt abdominal trauma.

AB - Objective: This study determined the sensitivity, specificity, and accuracy of CT in pediatric patients with blunt trauma. Correlation of the CT-identified injuries and intraoperative findings with comparison to the results of DPL was performed. Summary Background Data: Clinical evaluation frequently is unreliable in determining the presence of intra-abdominal injury in children with blunt trauma. Peritoneal lavage has been used to establish the need for operative intervention and has been found to be safe, efficient, and reliable (98%). In many institutions, abdominal CT scans are used to evaluate these children. Because most reports involve nonoperative management, operative confirmation of CT-identified injuries is available only for those children in whom nonoperative treatment is unsuccessful. Methods: Sixty children sustaining blunt abdominal trauma were included in the study. CT scans with both oral and IV contrast were performed before open lavage, and positive results were confirmed by operation in 18 patients. Results: CT had a sensitivity of 67%, however, only 60% of the actual organ injuries were identified by the scan. In contrast, DPL has a sensitivity of 94%. Both studies were equally specific (100%). DPL was also more accurate, 98% as compared with 89% for CT. Conclusions: Although the abdominal CT scan is useful in evaluating children with blunt abdominal trauma, a number of significant injuries were missed. Based on the low sensitivity of the CT, the authors suggest diagnostic peritoneal lavage may offer advantages over CT as the initial study in the evaluation of children with blunt abdominal trauma.

UR - http://www.scopus.com/inward/record.url?scp=0027467208&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027467208&partnerID=8YFLogxK

M3 - Article

VL - 217

SP - 272

EP - 276

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -