Evaluation of sentinel clot sign on computed tomography scan (CT scan) in order to know primary organ of injury in patients with blunt abdominal trauma: A retrospective study of 43 subjects

Introduction: Blunt abdominal trauma is one of the commonly encountered surgical emergencies. The diagnostic modality that helps in optimum management of these patients includes chest and abdominal x-rays, Focused Assessment Sonography for Trauma scan and Computed Tomography. In selected hemodynamically stable patients who are candidates for non-operative management, Contrast Enhanced Computed Tomography is not considered essential and hence avoiding its own radiation hazards and decreasing extra financial burden to the patients. Aims: To evaluate whether Contrast Enhanced Computed Tomography is necessary or not in case of blunt trauma abdomen. Methods: This is a hospital based prospective study done in the department of surgery at Nepalgunj Medical College, Kohalpur conducted from October 2020 to March 2021. The patients with blunt abdominal trauma who were hemodynamically stable at the time of presentation and those who became stable after resuscitation were included. These patient’s detailed history was taken, clinical examination done. Focused Assessment Sonography for Trauma scan was done at the time of presentation along with chest x-ray and other necessary blood investigation. Data were analyzed with Statistical Package for Social Sciences version 25 and p-value <0.05 was taken as significant. Results: Out of total 53 patients, age group between 11-20 and 21-30 years comprising of 13 patients with male: female ratio of 1.94:1 were affected more. Fall injury, being the most common mode, comprised 20 patients. The commonest organ involved was spleen seen in 17 patients (32.1%), liver in 16 patients (30.2%). In 44 (83.0%) patients, Computed Tomography scan was done only in nine patients who were also managed conservatively, except one who underwent laparoscopic evacuation of collected blood. Seventeen (32.1%) patients underwent repeat ultrasonography without any new findings. Conclusion: Patients with blunt abdominal trauma with stable hemodynamics can be managed conservatively with limited use of Contrast Enhanced Computed Tomography scan.

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Clinical recognition and management of pediatric blunt abdominal trauma without ultrasound or computed tomography scan in community hospitals in Mexico

Journal of Pediatric Surgery ◽

10.1016/s0022-3468(99)90648-6 ◽

1999 ◽

Vol 34 (11) ◽

pp. 1700-1702 ◽

Cited By ~ 2

Author(s):

Giovanni Porras-Ramírez ◽

Francisco Ramírez-Reyes ◽

Maía Helena Hernández-Herrera ◽

Juan Domingo Porras-Hernández

Keyword(s):

Computed Tomography ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Computed Tomography Scan ◽

Community Hospitals ◽

Tomography Scan

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Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries after Blunt Trauma: Correlation with Trauma Surgery Findings in 163 Patients

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.07.003 ◽

2017 ◽

Vol 68 (3) ◽

pp. 276-285 ◽

Cited By ~ 8

Author(s):

Francesco Cinquantini ◽

Gregorio Tugnoli ◽

Alice Piccinini ◽

Carlo Coniglio ◽

Sergio Mannone ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Predictive Value ◽

Gold Standard ◽

Clinical Management ◽

Trauma Surgery ◽

Trauma Patients ◽

Increased Risk

Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.

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Characterization of Cystic Lesions of Pancreas by Computed Tomography Scan- A Retrospective Study

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2020/158 ◽

2020 ◽

Vol 9 (10) ◽

pp. 726-730

Author(s):

Rajoo Ramachandran ◽

Kumaresh Athiyappan ◽

Prabhu Radhan Radhakrishnan ◽

Ananda Kumar Balasubramanian

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Cystic Lesions ◽

Computed Tomography Scan ◽

Tomography Scan

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Diagnostic Accuracy of CT Scans in Blunt Abdomical Trauma

10.53350/pjmhs2115103503 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3503-3505

Author(s):

Azmat Ali ◽

Nadia Khattak ◽

Adnan Ahmed ◽

Jawad Ali Memon ◽

Maimoona Afsar ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Accuracy ◽

Ct Scan ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Clinical Manifestations ◽

Retroperitoneal Hematoma ◽

Ct Scans ◽

Internal Bleeding ◽

Wide Range

Background and Aim: Blunt abdominal trauma may lead to a serious situation that necessitates prompt diagnosis and treatment. The intra-abdominal injury effective diagnosis is difficult in patient’s management in such cases. The present study aims to evaluate the diagnostic accuracy of computed tomography scans in active internal bleeding following abdominal trauma. Materials and Methods: This cross-sectional study was carried out on 84 blunt abdominal trauma patients in the Department of Radiology Hayatabad Medical Complex, Peshawar for duration of six months from January 2021 to June 2021. All the patients with no clinical manifestations underwent diagnostic CT scans. Those who had a positive CT scan underwent laparotomy. The remaining patients were monitored for 24 hours and were discharged in case of no serious issues. Demographic details, patient information, trauma mechanism, CT scan indications, and findings, and laparotomy results were recorded. Regarding injured organs, specificity, sensitivity, and diagnostic accuracy of CT scans were determined. For individual cases, CT scans specificity, sensitivity, and accuracy were calculated. SPSS version 20 was used for data analysis. Results: This study included 84 patients, out of which 73 (86.9%) were male and 11(13.1%) were female. Patients aged 20-40 years were more prevalent 47 (56%), followed by those aged over 40 years were 20 (23.8%) and 10 to 19 years old were 17 (20.2%). Liver and spleen injuries had the highest CT scan sensitivity of 87.5% and 96.7% respectively. On the other hand, The CT scan's specificity was high in the injured kidneys (94%) and retroperitoneal hematoma 97.3% compared to other organ’s injuries. The diagnostic accuracy of CT scans in the identification of liver, kidney injuries, spleen, and retroperitoneal hematoma injuries was 93.7%, 92.3%, 96.2%, and 92.3% respectively. Conclusion: Our study found that CT scans are capable of detecting a wide range of injuries. CT scans are exceptionally valuable for assessing blunt abdominal injuries with active internal bleeding patients Furthermore, CT investigation is quick and extensively accessible. CT can produce high-resolution images with MPR and scanning protocol. Keywords: Diagnostic Accuracy; Abdominal Trauma Injuries, Computed Tomography (CT)

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Hubungan Antara Kadar DNA Plasma Virus Epstein Barr Dengan Stadium Klinis Karsinoma Nasofaring WHO Tipe 3

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v48i2.277 ◽

2019 ◽

Vol 48 (2) ◽

pp. 165

Author(s):

Putranti Dyahayu Roziaty ◽

Soehartono Soehartono ◽

Hendradi Surjotomo

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Epstein Barr Virus ◽

Tumor Type ◽

Computed Tomography Scan ◽

Cross Sectional ◽

Barr Virus ◽

Ebv Dna ◽

Epstein Barr ◽

Tomography Scan

Latar Belakang: Karsinoma nasofaring (KNF) merupakan keganasan yang tersering ditemukan, dan berdampak pada penurunan kualitas hidup serta memiliki mortalitas tinggi. Penanganan KNF selama ini terkendala oleh waktu tunggu yang cukup lama dalam menentukan staging KNF terutama untuk antrian pemeriksaan computed tomography scan (CT scan) dan Ultrasonography (USG). Pemeriksaan kadar DNA EBV (Deoxyribonucleic acid Epstein-Barr Virus) pada pasien yang relatif lebih mudah dan terjangkau dapat digunakan untuk memprediksi stadium dan prognosis KNF. Dengan mengetahui prognosis KNF lebih dini, maka diharapkan penanganan terhadap KNF dapat segera dilakukan. Tujuan: Mengetahui apakah kadar DNA EBV dapat dipakai untuk memprediksi stadium dan prognosis KNF dengan cara mencari hubungan antara kadar DNA EBV dengan stadium KNF. Metode: Penelitian cross sectional melibatkan 15 subjek penelitian yang terdiagnosis KNF WHO tipe 3 kemudian dilakukan staging dengan CT scan, USG abdomen, dan foto toraks, serta diambil sampel darah untuk diukur kadar DNA EBV. Hasil: Seluruh subjek penelitian mengalami peningkatan kadar DNA EBV sesuai dengan peningkatan stadium KNF. Peningkatan stadium KNF berhubungan signifikan dengan peningkatan kadar DNA EBV (p=0,001). Ukuran tumor (T) berhubungan signifikan dengan kadar DNA EBV (p=0,023), ukuran nodul (N) berhubungan signifikan dengan kadar DNA EBV (p=0,005), ada tidaknya metastasis tidak berhubungan signifikan dengan kadar DNA EBV (p=0,398). Nilai cut off kadar DNA EBV sebesar 952 kopi/ml. Kesimpulan: Terdapat hubungan yang signifikan antara kadar DNA EBV dengan stadium klinis, dengan demikian kadar DNA EBV dapat dipertimbangkan untuk digunakan sebagai prediktor stadium dan prognosis KNF. Background: Nasopharyngeal carcinoma (NPC) is the predominant tumor type arising in the nasopharynx, with a high mortality and affecting quality of life. NPC treatment management is hindered by long queues of Computed Tomography Scan (CT scan) and Ultrasonography (USG) examinations to ascertain the NPC staging. The examination of Epstein-Barr Virus (EBV) DNA level is relatively simpler and inexpensive to predict the NPC staging and prognosis, thus, it can speed up NPC treatment. Objective: To determine whether EBV DNA level can be used to predict the NPC stage and prognosis by finding a correlation between EBV DNA level and NPC stage. Method: This was a cross-sectional study involving 15 respondents who were diagnosed as WHO type 3 NPC, and examined by CT scan, abdominal ultrasound, chest X-ray, and blood test for measuring the levels of EBV DNA to determine the stage. Results: All respondents had elevated levels of EBV DNA in accordance with NPC stage elevation. Increased NPC stages were significantly correlated with elevated levels of EBV DNA (p=0.001). The size of tumor (T) was significantly correlated with EBV DNA (p=0.023), the size of nodule (N) was significantly correlated with EBV DNA (p=0.005). The presence or absence of metastasis did not significantly correlate with EBV DNA (p=0.398). The EBV DNA cut off value was 952 copies/ml. Conclusions: There was a significant correlation between EBV DNA levels and clinical stages, hence EBV DNA can be considered to be used as NPC staging and prognosis predictor.

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Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1255 ◽

2016 ◽

Vol 9 (1) ◽

pp. 13-17

Author(s):

Priyanko Chakraborty ◽

Rajiv K Jain ◽

Purnima Joshi ◽

Rakhi Kumari ◽

Sidharth Pradhan

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Chronic Rhinosinusitis ◽

Sinus Surgery ◽

Anatomic Variations ◽

Review Of Literature ◽

Computed Tomography Scan ◽

Diagnostic Endoscopy ◽

The Mean ◽

Tomography Scan

ABSTRACT Background Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered. Materials and methods The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan. Results The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells. Conclusion Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery. How to cite this article Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

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