Perisplenic extravasation of contrast medium on enhanced helical computed tomography: a reliable indicator for early surgical management in blunt splenic injuries.

Yon Cheong Wong, Li Jen Wang, Jen Feng Fang, Chi Jen Chen, Being Chuan Lin, Ray Jade Chen

Research output: Chapter in Book/Report/Conference proceedingChapter

7 Citations (Scopus)

Abstract

BACKGROUND: The purpose of this study was to determine the predictive value of perisplenic contrast material extravasation (CME) on contrast-enhanced helical computed tomography (CT) for early surgical management in blunt splenic injuries. METHODS: During a 12-month period, 80 patients who underwent computed tomography (CT) examinations and were discharged with the diagnosis of blunt splenic injury were included in this retrospective study. All CT scans were reviewed for perisplenic CME and the grades of splenic injuries. Their medical charts were independently reviewed for the choice of treatment and the time interval between CT and spleen-related laparotomy. RESULTS: Of the 80 CT scans, six (7.5%) were positive and 74 (92.5%) were negative for perisplenic CME. Forty scans were of low-grade injuries, 40 were of high-grade injuries. All six (100%) patients with perisplenic CME underwent spleen-related surgery, whereas 29 (39.2%) patients without CME required surgery (p=0.005). The time interval between CT and laparotomy was 1.6 +/- 1.0 hours for patients with CME, and 7.6 +/- 12.9 hours for patients without CME (p=0.028). Similar comparisons of the laparotomy frequency and time intervals between CT and laparotomy in the low-grade and high-grade injury groups did not show any significant differences. CONCLUSION: Perisplenic CME detected on contrast-enhanced helical CT was a more reliable predictive criterion than the grading scheme based on the depth of lacerations for early surgical management in blunt splenic injuries.

Original languageEnglish
Title of host publicationChang Gung medical journal
Pages381-387
Number of pages7
Volume25
Edition6
Publication statusPublished - Jun 2002
Externally publishedYes

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Extravasation of Diagnostic and Therapeutic Materials
Nonpenetrating Wounds
Spiral Computed Tomography
Contrast Media
Tomography
Laparotomy
Wounds and Injuries
Spleen
Lacerations
Retrospective Studies

ASJC Scopus subject areas

  • Medicine(all)

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Perisplenic extravasation of contrast medium on enhanced helical computed tomography : a reliable indicator for early surgical management in blunt splenic injuries. / Wong, Yon Cheong; Wang, Li Jen; Fang, Jen Feng; Chen, Chi Jen; Lin, Being Chuan; Chen, Ray Jade.

Chang Gung medical journal. Vol. 25 6. ed. 2002. p. 381-387.

Research output: Chapter in Book/Report/Conference proceedingChapter

Wong, Yon Cheong ; Wang, Li Jen ; Fang, Jen Feng ; Chen, Chi Jen ; Lin, Being Chuan ; Chen, Ray Jade. / Perisplenic extravasation of contrast medium on enhanced helical computed tomography : a reliable indicator for early surgical management in blunt splenic injuries. Chang Gung medical journal. Vol. 25 6. ed. 2002. pp. 381-387
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N2 - BACKGROUND: The purpose of this study was to determine the predictive value of perisplenic contrast material extravasation (CME) on contrast-enhanced helical computed tomography (CT) for early surgical management in blunt splenic injuries. METHODS: During a 12-month period, 80 patients who underwent computed tomography (CT) examinations and were discharged with the diagnosis of blunt splenic injury were included in this retrospective study. All CT scans were reviewed for perisplenic CME and the grades of splenic injuries. Their medical charts were independently reviewed for the choice of treatment and the time interval between CT and spleen-related laparotomy. RESULTS: Of the 80 CT scans, six (7.5%) were positive and 74 (92.5%) were negative for perisplenic CME. Forty scans were of low-grade injuries, 40 were of high-grade injuries. All six (100%) patients with perisplenic CME underwent spleen-related surgery, whereas 29 (39.2%) patients without CME required surgery (p=0.005). The time interval between CT and laparotomy was 1.6 +/- 1.0 hours for patients with CME, and 7.6 +/- 12.9 hours for patients without CME (p=0.028). Similar comparisons of the laparotomy frequency and time intervals between CT and laparotomy in the low-grade and high-grade injury groups did not show any significant differences. CONCLUSION: Perisplenic CME detected on contrast-enhanced helical CT was a more reliable predictive criterion than the grading scheme based on the depth of lacerations for early surgical management in blunt splenic injuries.

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