Stab wounds to the back and flank in the hemodynamically stable patient: A decision algorithm based on contrast-enhanced computed tomography with colonic opacification

Orlando C. Kirton, Dylan Wint, Brenton Thrasher, Jimmy Windsor, Ana Echenique, Judith Hudson-Civetta

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

PURPOSE: The authors wanted to determine whether contrast-enhanced computed tomography (CE-CT) with colonic opacification is an accurate tool to triage hemodynamically stable victims of stab wounds to the flank and back. PATIENTS AND METHODS: One hundred forty-five consecutive patients were categorized as low-risk (penetration superficial to the deep fascia) or high- risk (penetration beyond the deep fascia) based on CE-CT findings. RESULTS: There were no significant differences in admission vital signs, Glasgow Coma Scale, or complete blood counts between low- and high-risk groups. None of the 92 low-risk patients required surgery or had sequelae. Six of the 53 high-risk patients underwent surgery, 2 based on initial CE-CT, 4 due to evolving clinical signs. The CE-CT correctly predicted surgical findings in all cases. CONCLUSIONS: Hemodynamically stable patients with stab wounds to the back and/or flank can be successfully triaged based on CE-CT findings. Low-risk patients may be discharged immediately. High-risk patients may have a discharge decision implemented at 24 hours.

Original languageEnglish (US)
Pages (from-to)189-193
Number of pages5
JournalAmerican journal of surgery
Volume173
Issue number3
DOIs
StatePublished - Mar 1997

ASJC Scopus subject areas

  • Surgery

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