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J Med Assoc Thai ; 97 Suppl 8: S15-21, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25518288

ABSTRACT

BACKGROUND: According to controversial guideline for management in case of hemodynamically stable blunt abdominal injury with microscopic hematuria. Most ofthe patients could be omittedfor abdominal computed tomography (CT). Despite high sensitivity and specificity ofabdominal CT, in addition to high medical cost, there are risks from radiation exposure and adverse reaction from use of contrast media. OBJECTIVE: To evaluate the prevalence ofKUB injury on abdominal CT in case of hemodynamically stable blunt abdominal injury with microscopic hematuria. MATERIAL AND METHOD: Forty-one studies of abdominal CT performed during 1 January 2010 and 30 June 2012 were retrospectively reviewed for KUB injury (categorized byAAST organ injury scale) by consensus oftwo experienced radiologists. RESULTS: KUB injury was found in 36.6%from all selected CTstudies. Almost all cases could be managed conservatively. The cutoffpoint of microscopic hematuria at 20 cells/hpfhas sensitivity 80% and specificity 46.15%. CONCLUSION: One-third ofthe patients have KUB injury but almost all ofthem could be conservatively managed. We proposed that the cutoffpoint of hematuria be equivalent to or greater than 20 cells/hpf to be one of the indicators for predicting KUB injury that needs radiological evaluation; but it should be carefully considered along with clinical information.


Subject(s)
Abdominal Injuries/diagnostic imaging , Kidney/injuries , Ureter/injuries , Urinary Bladder/injuries , Wounds, Nonpenetrating/diagnostic imaging , Abdominal Injuries/complications , Accidents, Traffic , Adolescent , Adult , Contrast Media , Female , Hematuria/etiology , Humans , Kidney/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray Computed , Ureter/diagnostic imaging , Urinary Bladder/diagnostic imaging , Wounds, Nonpenetrating/complications , Young Adult
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