Selective non-operative management of anterior abdominal stab wounds with emphasis on the value of follow-up abdominal CT scanning

Background and aim Selective non-operative management of patients with penetrating abdominal stabs is the preferred treatment strategy. The present study aimed to assess the efficacy and safety of non-operative management with emphasis on the value of follow-up abdominal CT scanning in management of patients with penetrating anterior abdominal stab. Patients and methods This is a retrospective chart review of stable patients with anterior abdominal stab wounds. Patients were divided in terms of initial decisions into two groups: laparotomy group and non-operative management group. Abdominal CT scan was performed for patients in the non-operative management group on admission and follow-up CT scanning was performed in cases of clinical and/or biochemical deterioration. Results The laparotomy group included 82 patients and 68.2% of them had unnecessary laparotomies. The non-operative management group comprised 97 patients and 90.7% of them did not require subsequent laparotomy. Abdominal CT scan had a sensitivity of 88.9% and specificity of 100% in detection of intra-abdominal injuries. Follow-up CT scanning detected bowel injuries missed by initial CT scan in three patients. The non-operative management group had significantly lower post-operative complication rate than the laparotomy group (4.1% vs. 18.3%), with a significantly shorter length of stay. Conclusions Non-operative management is the optimal management strategy for stable patients with penetrating anterior abdominal stab to decrease unnecessary laparotomy rates, hospital stay and costs. Follow-up abdominal CT scanning facilitated the decision making for patients selected for non-operative management and is highly sensitive in the diagnosis of patients who require subsequent exploration.

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Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

BMC Gastroenterology ◽

10.1186/s12876-021-01627-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhicheng Zhang ◽

Xiaowei Huang ◽

Qian Chen ◽

Demin Li ◽

Qi Zhou ◽

...

Keyword(s):

Small Intestine ◽

Case Report ◽

Literature Review ◽

Ct Scan ◽

Duplication Cyst ◽

Abdominal Ct ◽

Case Presentation ◽

Abdominal Ct Scan ◽

Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

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No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

Endoscopy International Open ◽

10.1055/a-0650-4478 ◽

2019 ◽

Vol 07 (02) ◽

pp. E308-E309

Author(s):

Thomas Walter

Keyword(s):

Natural History ◽

Ct Scan ◽

Neuroendocrine Tumors ◽

Surgical Procedures ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

Interesting Approach ◽

History Of ◽

Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

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Timing and Pattern of Recurrence after Gastrectomy for Adenocarcinoma

The American Surgeon ◽

10.1177/000313481508101029 ◽

2015 ◽

Vol 81 (10) ◽

pp. 1057-1060 ◽

Cited By ~ 3

Author(s):

Mohammad Alnoor ◽

Joshua A. Boys ◽

Stephanie G. Worrell ◽

Daniel S. Oh ◽

Jeffrey A. Hagen ◽

...

Keyword(s):

Ct Scan ◽

Gastric Adenocarcinoma ◽

Complete Resection ◽

High Recurrence Rate ◽

Abdominal Ct ◽

Time To Recurrence ◽

Abdominal Disease ◽

Abdominal Ct Scan ◽

Pattern Of Recurrence

Gastric adenocarcinoma has a high recurrence rate. The goal of this study was to determine the timing and pattern of recurrence after gastrectomy. A retrospective review was performed of patients with gastric adenocarcinoma having curative partial or total gastrectomy with R0/D2 lymph node resection from 1999 to 2013. Follow-up included CT scans of the chest, abdomen, and pelvis at 3-month intervals for the first three years, at 6-month intervals for the next two years, and annually thereafter. There were 62 patients, 38 males and 24 females, with a median age of 65 years. Median follow-up was 29 months and recurrence was identified in 21 per cent of patients. Median time to recurrence was 12 months and 92 per cent of recurrences occurred within two years. The last recurrence was identified at 34 months. Abdominal CT scan identified all patients with recurrence, although some patients had disease elsewhere in addition to the abdominal disease. There were no extra-abdominal isolated recurrences. In conclusion, recurrence after complete resection for gastric adenocarcinoma typically occurs within the first two years, and can be found by abdominal CT scan. Close cancer follow-up appears unnecessary after three years because all recurrences were identified within 34 months of resection.

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The Role of Abdominal CT Scan as Follow-up after Complete Remission with Successful Helicobacter pylori Eradication in Patients with H. pylori-Positive Stage IE1 Gastric MALT Lymphoma

Helicobacter ◽

10.1111/j.1523-5378.2010.00807.x ◽

2011 ◽

Vol 16 (1) ◽

pp. 36-41 ◽

Cited By ~ 4

Author(s):

Ji Young Choi ◽

Gin Hyug Lee ◽

Ji Yong Ahn ◽

Mi-Young Kim ◽

Jeong Hoon Lee ◽

...

Keyword(s):

Helicobacter Pylori ◽

Complete Remission ◽

Ct Scan ◽

Gastric Malt Lymphoma ◽

Abdominal Ct ◽

Helicobacter Pylori Eradication ◽

Abdominal Ct Scan ◽

H Pylori

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Intramural gastric hematoma imitating a gastrointestinal stromal tumor – case report and literature review

Polish Journal of Surgery ◽

10.5604/01.3001.0009.9159 ◽

2017 ◽

Vol 89 (2) ◽

pp. 62-65 ◽

Cited By ~ 1

Author(s):

Arkadiusz Spychała ◽

Piotr Nowaczyk ◽

Aleksandra Budnicka ◽

Ewa Antoniewicz ◽

Dawid Murawa

Keyword(s):

Case Report ◽

Gastrointestinal Stromal Tumor ◽

Ct Scan ◽

Histopathological Examination ◽

Posterior Wall ◽

Stromal Tumor ◽

Abdominal Ct ◽

Ki 67 ◽

Abdominal Ct Scan

The article presents a case report of a patient with an intramural gastric hematoma. Diagnostic examinations were suggestive of a suspected gastrointestinal stromal tumor Normal image was observed in gastroscopic examination while abdominal CT scan revealed a nodular lesion along the greater curvature of the stomach extending from the posterior wall and adjoining the pancreas and the spleen. The patient was qualified for surgical treatment. Laparotomy was performed followed by total gastric resection and Roux-en-Y reconstruction of the gastrointestinal tract. Post-operative histopathological examination revealed the presence of an extensive hematoma penetrating the perigastric fat tissue along with numerous hemosiderinophages and segmental indicators of formation of inflammatory granulation tissue suggestive of a chronic nature of the lesion. Immunohistochemical GIST assays (CD117, DOG-1, CD34, CD31, SMA, S-100, CKAE1/AE3, Ki-67) were negative. No complications were observed in the post-operative course. Patient is subject to continued follow-up and observation. Follow-up gastroscopy and abdominal CT scan performed 6 months after the surgery revealed an unremarkable image.

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TRAUMA GINJAL

Jurnal Radiologi Indonesia ◽

10.33748/jradidn.v4i1.89 ◽

2020 ◽

Vol 4 (1) ◽

pp. 52-57

Author(s):

Noflih Sulistia ◽

Bambang Soeprijanto ◽

Indrastuti Normahayu ◽

Lenny Violetta

Keyword(s):

Ct Scan ◽

Pediatric Patients ◽

Radiological Examination ◽

Renal Trauma ◽

Abdominal Ct ◽

Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

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Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

Korean Society of Computed Tomographic Technology ◽

10.31320/jksct.2018.20.2.123 ◽

2018 ◽

Vol 20 (2) ◽

pp. 123-132

Author(s):

Dae-hyun Park ◽

Young-Kyoon Kim ◽

Jong-Ho Ahn ◽

Kwang-Hyun Chang ◽

Yoon-Chul Nam ◽

...

Keyword(s):

Radiation Dose ◽

Ct Scan ◽

Dual Energy ◽

Abdominal Ct ◽

Abdominal Ct Scan

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Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review

Open Medicine ◽

10.1515/med-2020-0117 ◽

2020 ◽

Vol 15 (1) ◽

pp. 997-1002

Author(s):

Hao Wu ◽

Rui Zheng

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Ct Scan ◽

Splenic Abscess ◽

Low Density ◽

Abdominal Ct ◽

Streptococcus Anginosus ◽

Abdominal Ct Scan ◽

Tract Infections

AbstractOrgan abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.

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Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina ◽

10.3390/medicina57080734 ◽

2021 ◽

Vol 57 (8) ◽

pp. 734

Author(s):

Ivona Djordjevic ◽

Dragoljub Zivanovic ◽

Ivana Budic ◽

Ana Kostic ◽

Danijela Djeric

Keyword(s):

Splenic Abscess ◽

Operative Management ◽

High Energy ◽

Significant Difference ◽

Injury Grade ◽

Grade Ii ◽

The Mean ◽

Non Operative Management ◽

Grade Iii

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

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