Computed Tomography in the Workup of Patients with Penetrating Trauma

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Abstract

Penetrating trauma presents one area where operative management has long been considered the gold standard of care. When presented with a patent who has been the victim of a penetrating injury, physiologic status often dictates the need for rapid operative exploration with the goal of control of active hemorrhage and contamination from hollow viscus injuries. Certainly no qualified surgeon, when faced with a victim of penetrating trauma who is hemodynamically unstable with active hemorrhage or evidence of peritonitis, would seriously argue to undertake an extensive radiological workup. However, when faced with the stable patient, there is evolving evidence that information obtained from newer generation computed tomography (CT) scanners, augmented with contrast to allow for CT Angiography, can be valuable in guiding further care and limiting nontherapeutic operative exploration. While historically not always considered an area of major concern, these nontherapeutic explorations can be a significant source of morbidity and mortality as well as dramatically increasing the length of stay and overall cost. This chapter will examine some of the available evidence with regard to various anatomic locations and provide some guidelines for the appropriate use of CT imaging in the workup of the stable patient with penetrating trauma. Specifically, we will examine its use in the workup of penetrating injuries to the abdomen, back and flank, thorax, neck, and extremities.

Keywords

Compute Tomography Angiography Stable Patient Nonoperative Management Gunshot Wound Conventional Angiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of SurgeryState University of New York Upstate Medical UniversitySyracuseUSA

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