title: Peritoneal fluid of low CT Hounsfield units as a screening criterion for traumatic bowel perforation.
abstract: OBJECTIVE
  To investigate whether peritoneal fluid of low CT Hounsfield units is an important screening criterion for traumatic bowel perforation.
  
  
  METHODS
  We performed a retrospective study on two cohorts of blunt trauma patients who had peritoneal fluid. Intravenous and oral contrast was used for the first cohort (61 patients) as opposed to intravenous contrast only for the second cohort (60 patients). We compared the CT Hounsfield units of peritoneal fluid with bowel perforation. The optimal cutoff value of CT Hounsfield units was determined, and its diagnostic values for bowel perforation were calculated.
  
  
  RESULTS
  The mean CT Hounsfield units (HU) of peritoneal fluid with bowel perforation were significantly lower (30.3 ± 9.0 versus 44.1 ± 13.6 HU, p = 0.008) in the second cohort. The optimal cutoff value was 43 HU, and its sensitivity, specificity, accuracy and positive likelihood ratio were 100.0, 69.2, 73.3% and 3.3, respectively, for bowel perforation. Comparisons of CT HUs of peritoneal fluid with bowel perforation in the first cohort that used additional oral contrast for CT did not show statistically significant differences.
  
  
  CONCLUSIONS
  Peritoneal fluid of low CT HU is a sensitive and important CT screening criterion for traumatic bowel perforation.
authors.affiliation: Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan. ycwong@cgmh.org.tw.
authors.forename: Yon-Cheong
authors.identifier: http://orcid.org/0000-0001-8831-3295
authors.initials: YC
authors.lastname: Wong
authors.affiliation: Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan.
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan.
authors.forename: Huan-Wu
authors.initials: HW
authors.lastname: Chen
authors.affiliation: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan, Taoyuan, Taiwan.
authors.forename: Being-Chuan
authors.initials: BC
authors.lastname: Lin
authors.affiliation: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan, Taoyuan, Taiwan.
authors.forename: Yu-Pao
authors.initials: YP
authors.lastname: Hsu
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D000284:Administration, Oral; D000328:Adult; D001202:Ascitic Fluid / Q000473:pathology*; D015331:Cohort Studies; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D003287:Contrast Media
keywords: Bowel perforation; CT; Diagnostic values; Hounsfield unit; Peritoneal fluid