title: Accuracy of clinical, laboratory, and computed tomography findings for identifying hollow viscus injury in blunt trauma patients with unexplained intraperitoneal free fluid without solid organ injury.
abstract: BACKGROUND
  We sought to define the accuracy of findings for detecting hollow viscus injury (HVI) in patients with blunt abdominal trauma (BAT) and unexplained intra-peritoneal free fluid without solid organ injury (UIPFFWSOI).
  
  
  METHODS
  We screened all consecutive hemodynamically stable patients presenting to a quaternary-care trauma-centre who had an abdominal computed tomography (CT) scan for BAT and UIPFFWSOI (January 2007-December 2014).
  
  
  RESULTS
  Of 3796 patients identified during the study period, 39 presented with UIPFFWSOI. Fifteen underwent therapeutic laparotomy. Seatbelt sign (+LR approaches infinity), diffuse peritonitis (+LR approaches infinity), number of CT cuts with fluid (c-statistic = 0.65), and a lower arterial pH at presentation (c-statistic = 0.62) were most predictive of HVI. Patients operated on within 24 h had shorter stays than those operated on later (median 9 vs. 14 days, p = 0.03).
  
  
  CONCLUSIONS
  Our findings suggest that clinical examination and measurements of intraperitoneal fluid volume may help identify HVIs in BAT patients.
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Jost
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roberts
authors.affiliation: Department of Radiology, University of Calgary, Calgary, AB, Canada.
authors.forename: Todd
authors.initials: T
authors.lastname: Penney
authors.affiliation: Department of Radiology, University of Calgary, Calgary, AB, Canada.
authors.forename: Grant
authors.initials: G
authors.lastname: Brunet
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada; The Regional Trauma Services Foothills Medical Centre, University of Calgary, Calgary, AB, Canada.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada; The Regional Trauma Services Foothills Medical Centre, University of Calgary, Calgary, AB, Canada. Electronic address: Andrew.kirkpatrick@albertahealthservices.ca.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Kirkpatrick
mesh_terms: D000007:Abdominal Injuries / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010808:Physical Examination; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Diagnostic accuracy study; Hollow viscus injury; Unexplained intra-peritoneal free-fluid without solid organ injury; Wounds and injuries