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Stab wounds to the back and flank in the hemodynamically stable patient: A decision algorithm based on contrast-enhanced computed tomography with colonic opacification
Journal article   Open access   Peer reviewed

Stab wounds to the back and flank in the hemodynamically stable patient: A decision algorithm based on contrast-enhanced computed tomography with colonic opacification

Orlando C Kirton, Dylan Wint, Brenton Thrasher, Jimmy Windsor, Ana Echenique and Judith Hudson-Civetta
The American journal of surgery, Vol.173(3), pp.189-193
03/1997
DOI: 10.1016/S0002-9610(96)00010-4
PMID: 9124624
url
https://doi.org/10.1016/S0002-9610(96)00010-4View
Published (Version of record) Open Access

Abstract

The authors wanted to determine whether contrast-enhanced computed tomography (CE-CT) with colonic opacification is an accurate tool to triage hemodynamically stable victims of stab wounds to the flank and back. One hundred forty-five consecutive patients were categorized as low-risk (penetration superficial to the deep fascia) or high-risk (penetration beyond the deep fascia) based on CE-CT findings. There were no significant differences in admission vital signs, Glasgow Coma Scale, or complete blood counts between low- and high-risk groups. None of the 92 low-risk patients required surgery or had sequelae. Six of the 53 high-risk patients underwent surgery, 2 based on initial CE-CT, 4 due to evolving clinical signs. The CE-CT correctly predicted surgical findings in all cases. Hemodynamically stable patients with stab wounds to the back and/or flank can be successfully triaged based on CE-CT findings. Low-risk patients may be discharged immediately. High-risk patients may have a discharge decision implemented at 24 hours.

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