The role of abdominal CT in the evaluation of stab wounds to the back.
Two hundred five patients with stab wounds to the back were evaluated with CT scans using both oral and IV contrast material. One hundred sixty-nine patients had a negative scan. Thirty (17.8%) of the 169 patients were operated upon because of clinical concern. Injuries were found in two of these patients: a diaphragmatic injury in one and a combined diaphragmatic and liver injury in the other. None of the 139 patients observed developed any sequelae. Twenty of the 33 patients with a positive CT were taken to the operating room where 16 were found to have a significant injury. Seven of these 16 patients had additional injuries not identified on CT. There were four false positive scans. Thirteen patients with a positive scan and two patients with an equivocal scan were observed based upon clinical judgment. Ten of these 15 patients had minor isolated renal or hepatic injuries seen on scan. None of these developed complications. It is concluded that abdominal computed tomography, with a sensitivity of 89%, specificity of 98%, and accuracy of 97% is a reliable study in the evaluation of patients with stab wounds to the back.
Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
D M
DM
Meyer
E R
ER
Thal
J A
JA
Weigelt
H C
HC
Redman
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019567:Back Injuries; D002648:Child; D003974:Diatrizoate Meglumine; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014951:Wounds, Stab / Q000000981:diagnostic imaging*
D003974:Diatrizoate Meglumine