title: Diagnosing blunt hollow viscus injury: is computed tomography the answer?
abstract: BACKGROUND
  Blunt hollow viscus injury (BHVI) is challenging to diagnose. The purpose of this study was to determine the reliability of physical exam and the role of computed tomography (CT) in the diagnosis of BHVI.
  
  
  METHODS
  All blunt abdominal trauma (BAT) admissions to a level 1 trauma center from January 2009 through December 2011 were identified through the trauma registry. Data collected included demographics and findings on CT and physical exam.
  
  
  RESULTS
  Of 2,912 patients with blunt trauma, 340 had BAT, and 30 (9%) had BHVIs. The sensitivity and specificity of CT were 86% and 88%, respectively, whereas the sensitivity and specificity of clinical exam were 53% and 69%. Twenty-seven percent of patients with BAT and bladder injuries had concomitant BHVIs.
  
  
  CONCLUSIONS
  This is the largest single series of BHVI after BAT. CT is superior to clinical exam in establishing the diagnosis of BHVI. Although associated injuries are common, bladder injury may be an important marker for BHVI.
authors: Department of Surgery, University of Connecticut, Hartford, CT, USA. djoseph@harthosp.org
authors: D'Andrea K
authors: DK
authors: Joseph
authors: Anastasia
authors: A
authors: Kunac
authors: Rae Lynne
authors: RL
authors: Kinler
authors: Ilene
authors: I
authors: Staff
authors: Karyn L
authors: KL
authors: Butler
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D000328:Adult; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010808:Physical Examination; D012042:Registries; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013270:Stomach / Q000000981:diagnostic imaging / Q000293:injuries*; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology