title: The role of repeat computed tomography scan in the evaluation of blunt bowel injury.
abstract: The precise role of repeat abdominal computed tomography (CT) imaging in the diagnosis and management of bowel injury is unclear. We reviewed 540 patients with blunt abdominal trauma managed at a Level II trauma center over a 5-year period to better define the role of repeat imaging.  One hundred patients had a repeat abdominal CT scan within 72 hours of admission. These patients were young with multisystem injuries (mean ± standard deviation age, 34 ± 15 years; Injury Severity Score, 21 ± 12; Glasgow Coma Score [GCS], 12 ± 5). There were 14  patients with bowel injuries. All bowel-injured patients survived without abdominal morbidity. Time to repeat CT was shortest in the bowel injured group (20 ± 10 hours). The repeat CT was most helpful in patients with significant closed head injury (mean GCS, 3 ± 1) and in those  with occult bowel injury. The repeat scan resulted in a change in clinical management in 26 patients. Regarding the presence of bowel perforation, the follow-up scan enhanced sensitivity from 30 to 82 per cent. The repeat abdominal CT is best used selectively in patients with blunt abdominal  trauma and can provide clinically useful information to exclude bowel injury.
authors.affiliation: Department of Surgery Atlanta Medical Center and Surgical Health Collective, Atlanta, GA, USA. ContactUs@surgicalhealthcollective.com
authors.forename: Mark L
authors.initials: ML
authors.lastname: Walker
authors.forename: Ignatius
authors.initials: I
authors.lastname: Akpele
authors.forename: Stanston D
authors.initials: SD
authors.lastname: Spence
authors.forename: Vernon
authors.initials: V
authors.lastname: Henderson
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D003287:Contrast Media; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007422:Intestines / Q000000981:diagnostic imaging* / Q000293:injuries*; D007479:Iopamidol; D008297:Male; D011237:Predictive Value of Tests; D019233:Retreatment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000601:surgery*
chemical_list: D003287:Contrast Media; D007479:Iopamidol