THE CORRELATION OF CT SCAN IN THE MANAGEMENT OF PENETRATING ABDOMINAL INJURIES.

BACKGROUND: Penetrating abdominal trauma contributes significantly to the burden of disease in South Africa. The role of imaging, particularly CT scan in this subset of patients has yet to be established. In this study we reviewed patients with penetrating abdominal injuries and correlated the imaging and intra-operative findings.

METHOD: Over an 18-month period (June 2015 to January 2017), the database as well as patient records of all patients presenting with penetrating abdominal trauma were reviewed. Patients presenting with haemodynamic instability and peritonitis were excluded from the study and immediately underwent a laparatomy. Patients presenting with penetrating abdominal trauma and who were haemodynamically stable and not peritonitic had imaging done in the form of a CT Scan. The CT scan findings were then correlated with the intraoperative findings.

RESULTS: One hundred and thirty one patients with penetrating abdominal trauma were eligible for imaging. Fifty two patients had positive CT scan findings as well as positive intraoperative findings. Seventy nine (60%) had negative findings on CT scan. Off the 79 patients, 59 (74%) had negative imaging findings as well as negative intraoperative findings. Twenty (25%) had negative CT findings but positive intraoperative findings.

CONCLUSION: CT scan correlates poorly with intraoperative findings and thus is a poor modality for screening patients.