UMEM Educational Pearls

Title: CT scans still aren’t perfect

Category: Trauma

Keywords: Trauma, CT scan, gunshot wound (PubMed Search)

Posted: 11/10/2024 by Robert Flint, MD (Updated: 11/17/2024)
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This retrospective study illustrates that the use of CT scanning to identify injury in gun shot wounds to the abdomen is not sensitive or specific enough to obviate the need for laparotomy. “Admission hypotension, abdominal pain and/or peritonitis, evisceration, and a transabdominal trajectory were considered clear indications for laparotomy.”  If there is clear indication to go to the OR, stopping in CT does not add any benefit. 

References

The fallacy of a roadmap computed tomography after an abdominal gunshot wound: A road that leads to nowhere

Vasquez, Matthew MD; Dhillon, Navpreet K. MD; Feliciano, David V. MD, FACS, MAMSE†; Scalea, Thomas M. MD, FACS, MCCM

Journal of Trauma and Acute Care Surgery 97(5):p 785-790, November 2024. | DOI: 10.1097/TA.0000000000004404