title: Stab wounds to the back and flank in the hemodynamically stable patient: a decision algorithm based on contrast-enhanced computed tomography with colonic opacification.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Division of Trauma University of Miami/Jackson Memorial Medical Center, Florida 33101, USA.
authors.forename: O C
authors.initials: OC
authors.lastname: Kirton
authors.forename: D
authors.initials: D
authors.lastname: Wint
authors.forename: B
authors.initials: B
authors.lastname: Thrasher
authors.forename: J
authors.initials: J
authors.lastname: Windsor
authors.forename: A
authors.initials: A
authors.lastname: Echenique
authors.forename: J
authors.initials: J
authors.lastname: Hudson-Civetta
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D019567:Back Injuries; D003106:Colon / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D013898:Thoracic Injuries / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014218:Triage; D014951:Wounds, Stab / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D003287:Contrast Media