Taiwan: Free peritoneal fluid (FF) on computed tomography (CT) is modestly sensitive and specific for surgically important traumatic bowel mesenteric injury (TBMI), suggests a recent study. The study was published in the journal Diagnostics on 2 November 2021.
"Our results provide the most robust evidence to date that after blunt abdominal trauma FF is not the absolute but an acceptable indicator for surgically important TBMI," wrote the authors. "However, still there is a need for randomized controlled trials to confirm these results."
TBMI, an uncommon but high-risk form of blunt abdominal injury, is a challenge in trauma care. After blunt trauma, bowel and mesenteric injuries are infrequent, reported among 5% of abdominal trauma, but they are nevertheless dangerous. TBMI can result in significant blood loss from disrupted mesenteric vessels immediately and remotely from injury time.
The presence of FF in CT is considered the indication for surgical intervention. However, conservative treatment should be applied for minor injuries. Szu-An Chen, Chang Gung University, Taoyuan, Taiwan, and colleagues conducted a systematic review to analyze how reliable the FF is to assess the TBMI.
For this purpose, the researchers retrieved publications by structured searching among databases, reviewing articles, and major textbooks. Using hierarchical models, summary receiver operating characteristic curves (SROCs) were computed for statistical analysis.
A total of 14 studies enrolling 4336 patients were eligible for final qualitative analysis.
The researchers found that the summary sensitivity of FF to predict surgical TBMI was 0.793, and the summary specificity of FF to predict surgical TBMI was 0.733. The diagnostic odds ratio was 10.531.
"This systematic review summarizes the studies' results presenting the incidence and predicting ability of the free fluid in diagnosing surgically important TBMI," the authors stated.
Reference:
Chen, S.-A.; Wang, C.-Y.; Hsu, C.-P.; Lin, J.-Y.; Cheng, C.-T.; Ouyang, C.-H.; Huang, J.-F.; Liao, C.-H. The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis. Diagnostics 2021, 11, 2028. https://doi.org/10.3390/diagnostics11112028
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.