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 Citations (Scopus)

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

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Stab Wounds
Tomography
Fascia
Glasgow Coma Scale
Blood Cell Count
Vital Signs
Triage

ASJC Scopus subject areas

  • Surgery

Cite this

Stab wounds to the back and flank in the hemodynamically stable patient : A decision algorithm based on contrast-enhanced computed tomography with colonic opacification. / Kirton, Orlando C.; Wint, Dylan; Thrasher, Brenton; Windsor, Jimmy; Echenique, Ana; Hudson-Civetta, Judith.

In: American Journal of Surgery, Vol. 173, No. 3, 03.1997, p. 189-193.

Research output: Contribution to journalArticle

Kirton, Orlando C. ; Wint, Dylan ; Thrasher, Brenton ; Windsor, Jimmy ; Echenique, Ana ; Hudson-Civetta, Judith. / Stab wounds to the back and flank in the hemodynamically stable patient : A decision algorithm based on contrast-enhanced computed tomography with colonic opacification. In: American Journal of Surgery. 1997 ; Vol. 173, No. 3. pp. 189-193.
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