Can multidetector CT detect the site of gastrointestinal tract injury in trauma? - A retrospective study

Ananya Panda; Atin Kumar; Shivanand Gamanagatti; Ranjita Das; Swati Paliwal; Amit Gupta; Subodh Kumar

doi:10.5152/dir.2016.15481

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Can multidetector CT detect the site of gastrointestinal tract injury in trauma? - A retrospective study

Journal article

Open access

Peer reviewed

Can multidetector CT detect the site of gastrointestinal tract injury in trauma? - A retrospective study

Ananya Panda, Atin Kumar, Shivanand Gamanagatti, Ranjita Das, Swati Paliwal, Amit Gupta and Subodh Kumar

Diagnostic and interventional radiology (Ankara, Turkey), Vol.23(1), pp.29-36

01/01/2017

DOI: 10.5152/dir.2016.15481

PMCID: PMC5214073

PMID: 27924777

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Abstract

We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites.

Adolescent

Adult

Child

Child, Preschool

Female

Gastrointestinal Tract - injuries

Humans

Intestine, Large - diagnostic imaging

Intestine, Small - diagnostic imaging

Male

Mesentery - injuries

Middle Aged

Multidetector Computed Tomography - methods

Multiple Trauma - diagnostic imaging

Retrospective Studies

Sensitivity and Specificity

Wounds and Injuries - diagnostic imaging

Young Adult

Details

Title: Subtitle: Can multidetector CT detect the site of gastrointestinal tract injury in trauma? - A retrospective study
Creators: Ananya Panda - All India Institute of Medical Sciences
Atin Kumar - All India Institute of Medical Sciences
Shivanand Gamanagatti - All India Institute of Medical Sciences
Ranjita Das - All India Institute of Medical Sciences
Swati Paliwal - All India Institute of Medical Sciences
Amit Gupta - All India Institute of Medical Sciences
Subodh Kumar - All India Institute of Medical Sciences
Resource Type: Journal article
Publication Details: Diagnostic and interventional radiology (Ankara, Turkey), Vol.23(1), pp.29-36
Publisher: Galenos Yayinevi
DOI: 10.5152/dir.2016.15481
PMID: 27924777
PMCID: PMC5214073
ISSN: 1305-3825
eISSN: 1305-3612
Language: English
Date published: 01/01/2017
Academic Unit: Radiology
Record Identifier: 9984697631702771

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