RESUMO
INTRODUCTION: Most patients admitted with an acute surgical problem undergo some imaging during their in-patient stay. As computed tomography (CT) scanning becomes more readily available, it is becoming the mainstay of assessment. Recent studies have commented on the potential adverse effects of early cross-sectional imaging. This audit aimed to determine the use of early cross-sectional imaging and associated radiation dose in an acute surgical cohort. PATIENTS AND METHODS: Data from 500 acute surgical patients were prospectively collected over a 3-month period. CT scans were undertaken, the effect on subsequent diagnostic and management decisions and the potential associated risks were evaluated. RESULTS: Almost 40% of subjects underwent CT scanning. Of these, 20% did not alter management and could be deemed unnecessary. The radiation exposure equated to an age- and gender-specific risk of fatal cancer induction between 1 in 1675 and 1 in 7130. CONCLUSIONS: Early-cross sectional imaging provides a valuable diagnostic adjunct. Decisions to expose patients to potentially hazardous radiation need to acknowledge the anticipated benefits versus risks.
Assuntos
Neoplasias Induzidas por Radiação/etiologia , Doses de Radiação , Tomografia Computadorizada por Raios X/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/mortalidade , Medição de Risco , Adulto JovemRESUMO
Endemic to over 70 countries and resulting in 200 million infected individuals and 500,000 deaths each year, the Schistosoma trematode worm can result in multisystem morbidity. Bowel obstruction secondary to this parasite has previously been described, but we report the first case of schistosomiasis affecting the sigmoid colon and resulting in perforation in a male positive for human immunodeficiency virus.
