HAL will be down for maintenance from Friday, June 10 at 4pm through Monday, June 13 at 9am. More information
Skip to Main content Skip to Navigation
Journal articles

Value of early repeated abdominal CT in selective non-operative management for blunt bowel and mesenteric injury

Abstract : Objectives To evaluate the performance of an early repeated computed tomography (rCT) in initially non-operated patients with blunt bowel and mesenteric injuries (BBMI). Methods This was a monocentric retrospective observational study from 2009 to 2017 of patients with a BBMI on initial CT (iCT). Patients initially non-operated on were scheduled for a rCT within 48 h. Initial CT and rCT diagnostic performance were compared based on a surgical injury prediction score previously described. For statistical analysis, we used the chi-square analyses for paired data (McNemar test). Results Eighty-four patients (1.9% of trauma) had suspected BBMI on iCT. Among these patients, 22 (26.2%) were initially operated on, 18 (21.4%) were later operated on, and 44 (52.4%) were not operated on. The therapeutic laparotomy rate was 85%. Thirty-four patients initially non-operated on had a rCT. The absolute value of the CT scan score increased for 15 patients (44.1%). The early rCT diagnostic performance, compared with iCT, showed an increase in sensitivity (from 63.6 to 91.7%), in negative predictive value (from 77.4 to 94.7%), and in AUC (from 0.77 to 0.94). Conclusion In initially non-operated patients with BBMI lesions, the performance of an early rCT improved the sensitivity of lesion detection requiring surgical repair and the security of patient selection for non-operative treatment.
Complete list of metadata

Contributor : Isabelle Combe Connect in order to contact the contributor
Submitted on : Monday, January 20, 2020 - 1:31:02 PM
Last modification on : Thursday, April 14, 2022 - 10:21:52 AM



F. Lannes, U. Scemama, A. Maignan, L. Boyer, L. Beyer-Berjot, et al.. Value of early repeated abdominal CT in selective non-operative management for blunt bowel and mesenteric injury. European Radiology, Springer Verlag, 2019, 29 (11), pp.5932-5940. ⟨10.1007/s00330-019-06212-w⟩. ⟨hal-02445697⟩



Record views