Significance of peritoneal fluid as an isolated finding on abdominal computed tomographic scans in pediatric trauma patients.

F. Hulka, Richard Mullins, V. Leonardo, M. W. Harrison, P. Silberberg

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Peritoneal fluid on abdominal computed tomographic (CT) scan in the absence of solid-organ injury suggests a bowel injury. We sought to determine the significance of peritoneal fluid as the sole finding on abdominal CT scans obtained to evaluate injured pediatric patients. METHODS: We performed a retrospective review of abdominal CT scans obtained during the initial survey of blunt trauma patients less than 19 years old during a 5-year period (1991-1995). All patients received intravenous and oral contrast agents. All CT scans were read by a staff radiologist. All CT scan results were retrospectively verified by one of the authors. RESULTS: Of the 259 scans, 157 (59%) were read as normal; 76 (31%) demonstrated solid-organ injury or pelvic fracture; 2 (1%) had pneumoperitoneum and 24 (9%) had peritoneal fluid as the only finding. Quantification of the fluid was done using a previously described method. Of the 16 patients with a small amount of fluid, only 2 (12%) required celiotomy. Of the eight patients with a moderate amount of fluid, four (50%) required celiotomy. At celiotomy, the six patients all had small-bowel injuries. No abdominal CT scan demonstrated extravasation of oral contrast. CONCLUSION: Intra-abdominal fluid as the sole finding on abdominal CT scan does not mandate immediate celiotomy in the bluntly injured pediatric patient. The patient with fluid in more than one location has a 50% chance of bowel injury. We also conclude that extravasated enteral contrast is rarely present to aid in the diagnosis of bowel injury in children.

Original languageEnglish (US)
Pages (from-to)1069-1072
Number of pages4
JournalThe Journal of trauma
Volume44
Issue number6
StatePublished - Jun 1998

Fingerprint

Ascitic Fluid
Pediatrics
Wounds and Injuries
Pneumoperitoneum
Contrast Media
Small Intestine

ASJC Scopus subject areas

  • Surgery

Cite this

Significance of peritoneal fluid as an isolated finding on abdominal computed tomographic scans in pediatric trauma patients. / Hulka, F.; Mullins, Richard; Leonardo, V.; Harrison, M. W.; Silberberg, P.

In: The Journal of trauma, Vol. 44, No. 6, 06.1998, p. 1069-1072.

Research output: Contribution to journalArticle

@article{e5e8e3e20622456385e53b5f6ce9145a,
title = "Significance of peritoneal fluid as an isolated finding on abdominal computed tomographic scans in pediatric trauma patients.",
abstract = "BACKGROUND: Peritoneal fluid on abdominal computed tomographic (CT) scan in the absence of solid-organ injury suggests a bowel injury. We sought to determine the significance of peritoneal fluid as the sole finding on abdominal CT scans obtained to evaluate injured pediatric patients. METHODS: We performed a retrospective review of abdominal CT scans obtained during the initial survey of blunt trauma patients less than 19 years old during a 5-year period (1991-1995). All patients received intravenous and oral contrast agents. All CT scans were read by a staff radiologist. All CT scan results were retrospectively verified by one of the authors. RESULTS: Of the 259 scans, 157 (59{\%}) were read as normal; 76 (31{\%}) demonstrated solid-organ injury or pelvic fracture; 2 (1{\%}) had pneumoperitoneum and 24 (9{\%}) had peritoneal fluid as the only finding. Quantification of the fluid was done using a previously described method. Of the 16 patients with a small amount of fluid, only 2 (12{\%}) required celiotomy. Of the eight patients with a moderate amount of fluid, four (50{\%}) required celiotomy. At celiotomy, the six patients all had small-bowel injuries. No abdominal CT scan demonstrated extravasation of oral contrast. CONCLUSION: Intra-abdominal fluid as the sole finding on abdominal CT scan does not mandate immediate celiotomy in the bluntly injured pediatric patient. The patient with fluid in more than one location has a 50{\%} chance of bowel injury. We also conclude that extravasated enteral contrast is rarely present to aid in the diagnosis of bowel injury in children.",
author = "F. Hulka and Richard Mullins and V. Leonardo and Harrison, {M. W.} and P. Silberberg",
year = "1998",
month = "6",
language = "English (US)",
volume = "44",
pages = "1069--1072",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Significance of peritoneal fluid as an isolated finding on abdominal computed tomographic scans in pediatric trauma patients.

AU - Hulka, F.

AU - Mullins, Richard

AU - Leonardo, V.

AU - Harrison, M. W.

AU - Silberberg, P.

PY - 1998/6

Y1 - 1998/6

N2 - BACKGROUND: Peritoneal fluid on abdominal computed tomographic (CT) scan in the absence of solid-organ injury suggests a bowel injury. We sought to determine the significance of peritoneal fluid as the sole finding on abdominal CT scans obtained to evaluate injured pediatric patients. METHODS: We performed a retrospective review of abdominal CT scans obtained during the initial survey of blunt trauma patients less than 19 years old during a 5-year period (1991-1995). All patients received intravenous and oral contrast agents. All CT scans were read by a staff radiologist. All CT scan results were retrospectively verified by one of the authors. RESULTS: Of the 259 scans, 157 (59%) were read as normal; 76 (31%) demonstrated solid-organ injury or pelvic fracture; 2 (1%) had pneumoperitoneum and 24 (9%) had peritoneal fluid as the only finding. Quantification of the fluid was done using a previously described method. Of the 16 patients with a small amount of fluid, only 2 (12%) required celiotomy. Of the eight patients with a moderate amount of fluid, four (50%) required celiotomy. At celiotomy, the six patients all had small-bowel injuries. No abdominal CT scan demonstrated extravasation of oral contrast. CONCLUSION: Intra-abdominal fluid as the sole finding on abdominal CT scan does not mandate immediate celiotomy in the bluntly injured pediatric patient. The patient with fluid in more than one location has a 50% chance of bowel injury. We also conclude that extravasated enteral contrast is rarely present to aid in the diagnosis of bowel injury in children.

AB - BACKGROUND: Peritoneal fluid on abdominal computed tomographic (CT) scan in the absence of solid-organ injury suggests a bowel injury. We sought to determine the significance of peritoneal fluid as the sole finding on abdominal CT scans obtained to evaluate injured pediatric patients. METHODS: We performed a retrospective review of abdominal CT scans obtained during the initial survey of blunt trauma patients less than 19 years old during a 5-year period (1991-1995). All patients received intravenous and oral contrast agents. All CT scans were read by a staff radiologist. All CT scan results were retrospectively verified by one of the authors. RESULTS: Of the 259 scans, 157 (59%) were read as normal; 76 (31%) demonstrated solid-organ injury or pelvic fracture; 2 (1%) had pneumoperitoneum and 24 (9%) had peritoneal fluid as the only finding. Quantification of the fluid was done using a previously described method. Of the 16 patients with a small amount of fluid, only 2 (12%) required celiotomy. Of the eight patients with a moderate amount of fluid, four (50%) required celiotomy. At celiotomy, the six patients all had small-bowel injuries. No abdominal CT scan demonstrated extravasation of oral contrast. CONCLUSION: Intra-abdominal fluid as the sole finding on abdominal CT scan does not mandate immediate celiotomy in the bluntly injured pediatric patient. The patient with fluid in more than one location has a 50% chance of bowel injury. We also conclude that extravasated enteral contrast is rarely present to aid in the diagnosis of bowel injury in children.

UR - http://www.scopus.com/inward/record.url?scp=34548055505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548055505&partnerID=8YFLogxK

M3 - Article

C2 - 9637164

VL - 44

SP - 1069

EP - 1072

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 6

ER -