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CT scan in the evaluation of pediatric abdominal trauma

OBJECTIVE: to assess the need of computed tomography (CT) for the definition of management in pediatric abdominal trauma. METHODS: observational retrospective study with patients under 18 years old victims of blunt or penetrating abdominal trauma that underwent CT of the abdomen and pelvis at admiss...

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Autores principales: PERIN, ISABELLA, GUETTER, CAMILA ROGINSKI, KLÜPPEL, LÚCIO EDUARDO, FACHIN, CAMILA GIRARDI, TCBC-PR, SILVANIA KLUG PIMENTEL
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Colégio Brasileiro de Cirurgiões 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578840/
https://www.ncbi.nlm.nih.gov/pubmed/36515330
http://dx.doi.org/10.1590/0100-6991e-20223246-en
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author PERIN, ISABELLA
GUETTER, CAMILA ROGINSKI
KLÜPPEL, LÚCIO EDUARDO
FACHIN, CAMILA GIRARDI
TCBC-PR, SILVANIA KLUG PIMENTEL
author_facet PERIN, ISABELLA
GUETTER, CAMILA ROGINSKI
KLÜPPEL, LÚCIO EDUARDO
FACHIN, CAMILA GIRARDI
TCBC-PR, SILVANIA KLUG PIMENTEL
author_sort PERIN, ISABELLA
collection PubMed
description OBJECTIVE: to assess the need of computed tomography (CT) for the definition of management in pediatric abdominal trauma. METHODS: observational retrospective study with patients under 18 years old victims of blunt or penetrating abdominal trauma that underwent CT of the abdomen and pelvis at admission. We evaluated CT scan findings, indications and management. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of clinical variables and energy of trauma for findings on CT. RESULTS: among the 236 patients included in our study, 72% (n=170) did not present abnormal findings on CT. It was performed surgical treatment in 15% (n=10), conservative treatment in 54,5% (n=36) and 27% (n=18) did not receive treatment for abdominal injuries. In the assessment of CT indications, 28,8% (n=68) presented no justifications. In this group, 91% (n=62) did not show any abnormal findings. Among the six patients with positive findings, half were selected for conservative treatment, while the rest did not need any treatment for abdominal injuries. The presence of abdominal pain, hemodynamic alterations and high energy blunt trauma had low positive predictive values when isolated, whereas the negative predictive values were higher. CONCLUSION: although CT is necessary in some instances, there is a possible high number of exams that did not make any difference in the management of the pediatric population.
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spelling pubmed-105788402023-10-17 CT scan in the evaluation of pediatric abdominal trauma PERIN, ISABELLA GUETTER, CAMILA ROGINSKI KLÜPPEL, LÚCIO EDUARDO FACHIN, CAMILA GIRARDI TCBC-PR, SILVANIA KLUG PIMENTEL Rev Col Bras Cir Original Article OBJECTIVE: to assess the need of computed tomography (CT) for the definition of management in pediatric abdominal trauma. METHODS: observational retrospective study with patients under 18 years old victims of blunt or penetrating abdominal trauma that underwent CT of the abdomen and pelvis at admission. We evaluated CT scan findings, indications and management. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of clinical variables and energy of trauma for findings on CT. RESULTS: among the 236 patients included in our study, 72% (n=170) did not present abnormal findings on CT. It was performed surgical treatment in 15% (n=10), conservative treatment in 54,5% (n=36) and 27% (n=18) did not receive treatment for abdominal injuries. In the assessment of CT indications, 28,8% (n=68) presented no justifications. In this group, 91% (n=62) did not show any abnormal findings. Among the six patients with positive findings, half were selected for conservative treatment, while the rest did not need any treatment for abdominal injuries. The presence of abdominal pain, hemodynamic alterations and high energy blunt trauma had low positive predictive values when isolated, whereas the negative predictive values were higher. CONCLUSION: although CT is necessary in some instances, there is a possible high number of exams that did not make any difference in the management of the pediatric population. Colégio Brasileiro de Cirurgiões 2022-11-23 /pmc/articles/PMC10578840/ /pubmed/36515330 http://dx.doi.org/10.1590/0100-6991e-20223246-en Text en © 2022 Revista do Colégio Brasileiro de Cirurgiões https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
PERIN, ISABELLA
GUETTER, CAMILA ROGINSKI
KLÜPPEL, LÚCIO EDUARDO
FACHIN, CAMILA GIRARDI
TCBC-PR, SILVANIA KLUG PIMENTEL
CT scan in the evaluation of pediatric abdominal trauma
title CT scan in the evaluation of pediatric abdominal trauma
title_full CT scan in the evaluation of pediatric abdominal trauma
title_fullStr CT scan in the evaluation of pediatric abdominal trauma
title_full_unstemmed CT scan in the evaluation of pediatric abdominal trauma
title_short CT scan in the evaluation of pediatric abdominal trauma
title_sort ct scan in the evaluation of pediatric abdominal trauma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578840/
https://www.ncbi.nlm.nih.gov/pubmed/36515330
http://dx.doi.org/10.1590/0100-6991e-20223246-en
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