Free fluid on CT, acceptable indicator for surgery in traumatic bowel mesenteric injury: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-12-18T09:00:05+05:30 | Updated On 18 Dec 2021 9:00 AM IST

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

Diagnostics journalfree peritoneal fluidMesenteric Trauma

Source : Diagnostics journal

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751