Comparison of positive predictive value of computed tomography versus diagnostic peritoneal lavage for diagnosis of solid organ damage in patients with blunt abdominal trauma

  • Abdul Ghaffar Lahore General Hospital, Lahore.
  • Saeed Mahmood Lahore General Hospital, Lahore.
  • Muhammad Kareemullah Lahore General Hospital, Lahore.
  • Saqib Uddin Khan Pak Red Crescent Medical & Dental College, Lahore
  • Ambreen Akram
  • Umar Niazi PGMI/AMC/LGH.
  • Afsar Ali Bhatti Lahore General Hospital, Lahore.
Keywords: Computed Tomography, Diagnostic Peritoneal Lavage, Solid Organ Damage, Blunt Abdominal Trauma

Abstract

Background: Abdominal trauma can be mysterious to some practitioners. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, eFAST Scan, DPL and CT scans, patients can be quickly and efficiently evaluated. Objectives: To determine the positive predictive value (PPV) of computed tomography and diagnostic peritoneal lavage for diagnosis of solid organ damage in patients with blunt abdominal trauma (BAT) taking surgical findings as gold standard. Study Design: Cross sectional study. Setting: Department of Surgery at Lahore General Hospital, Lahore. Period: Six months i.e. from 21.5.2016 to 20.11.2016. Materials and Methods: Data Collection: CT scan was performed with oral and intravenous contrast. DPL was done with sample assessment. Only those cases were included with positive findings in CT Scan or DPL. These patients underwent laparotomy under general anesthesia by a one standard surgical team. Results of surgical findings were compared between groups with CT scan and DPL. All the information was collected on predesigned proforma. Results: The mean age of the patients was 44.48±14.83 years. There were 66 (55%) males and 54 (45%) females in our study. In this study PPV for CT-scan group was 90.1% while PPV for group with DPL was 51.3%. Conclusion: PPV for CT Scan group was higher than that of DPL group for diagnosing solid organ damage in patients with BAT. Hence, evidence shows that CT Scan should be used as an initial investigation of choice in haemo-dynamically stable patients with BAT.

Author Biographies

Abdul Ghaffar, Lahore General Hospital, Lahore.

FCPS

Senior Registrar

Department of Surgical Unit II

Saeed Mahmood, Lahore General Hospital, Lahore.

FCPS

Associate Professor

Department of Surgery

Muhammad Kareemullah, Lahore General Hospital, Lahore.

FCPS

Associate Professor

Department of Surgery

Saqib Uddin Khan, Pak Red Crescent Medical & Dental College, Lahore

MBBS

Senior Registrar

Ambreen Akram

MBBS

Medical Officer

Umar Niazi, PGMI/AMC/LGH.

MBBS

Registrar

Afsar Ali Bhatti, Lahore General Hospital, Lahore.

FCPS

Head

Department of Surgical Unit II,

 

Published
2019-06-10