Isolated free intra-abdominal fluid on CT in blunt trauma: The continued diagnostic dilemma / 中华创伤杂志(英文版)
Chinese Journal of Traumatology
;
(6): 357-359, 2015.
Article
in English
| WPRIM
| ID: wpr-235801
ABSTRACT
<p><b>PURPOSE</b>The clinical significance of isolated free fluid (FF) without solid organ injury on computed to- mography (CT) continues to pose significant dilemma in the management of patients with blunt abdominal trauma (BAT).</p><p><b>METHODS</b>We reviewed the incidence of FF and the clinical outcome amongst patients with blunt abdominal trauma in a metropolitan trauma service in South Africa. We performed a retrospective study of 121 consecutive CT scans over a period of 12 months to determine the incidence of isolated FF and the clinical outcome of patients managed in a large metropolitan trauma service.</p><p><b>RESULTS</b>Of the 121 CTs, FF was identified in 36 patients (30%). Seven patients (6%) had isolated FF. Of the 29 patients who had free fluid and associated organ injuries, 33 organ injuries were identified. 86% (25/ 29) of all 29 patients had a single organ injury and 14% had multiple organ injuries. There were 26 solid organ injuries and 7 hollow organ injuries. The 33 organs injured were spleen, 12; liver, 8; kidney, 5; pancreas, 2; small bowel, 4; duodenum, 1. Six (21%) patients required operative management for small bowel perforations in 4 cases and pancreatic tail injury in 2 cases. All 7 patients with isolated FF were initially observed, and 3 (43%) were eventually subjected to operative intervention. They were found to have an intra-peritoneal bladder rupture in 1 case, a non-expanding zone 3 haematoma in 1 case, and a negative laparotomy in 1 case. Four (57%) patients were successfully managed without surgical interventions.</p><p><b>CONCLUSIONS</b>Isolated FF is uncommon and the clinical significance remains unclear. Provided that reli- able serial physical examination can be performed by experienced surgeons, an initial non-operative approach should be considered.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
South Africa
/
Wounds, Nonpenetrating
/
Body Fluids
/
Diagnostic Imaging
/
Tomography, X-Ray Computed
/
Retrospective Studies
/
Abdominal Injuries
Type of study:
Diagnostic study
/
Observational study
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
English
Journal:
Chinese Journal of Traumatology
Year:
2015
Type:
Article
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