Single-Contrast CT Accurately Shows Bowel Injuries

Single-contrast CT accuracy for showing bowel injuries related to penetrating abdominopelvic trauma is comparable with that of triple-contrast CT, according to a study published in the American Journal of Roentgenology.

Researchers from the Washington University in St. Louis School of Medicine in Missouri performed a retrospective review to assess the accuracy of single-contrast CT for diagnosing bowel injuries in cases of penetrating abdominopelvic trauma.

The researchers reviewed the records of 274 patients, median age of 27 years old, who had presented to the emergency room with penetrating abdominopelvic trauma and had undergone an abdominopelvic CT and surgery. They reviewed details regarding injury sites, the number of injuries per patient, and the type of weapon used. CT reports were correlated with operative notes for presence and sites of bowel injury.

The results showed that 77 percent of the patients had sustained gunshot wounds (GSWs), and CT showed bowel injury in 173 cases. Surgery revealed bowel injury in 162 cases. CT showed:

• 142 true-positive cases
• 31 false-positive cases
• 81 true-negative cases
• 20 false-negative cases

These findings resulted in sensitivity of 88 percent, specificity of 72 percent, positive predictive value of 82 percent, and negative predictive value of 80 percent for detecting bowel injuries. CT had the highest sensitivity and specificity in patients with multiple GSWs (94 percent and 79 percent, respectively) and those with injuries to the stomach and rectum.

The researchers concluded that single-contrast CT can show bowel injuries in patients with penetrating abdominopelvic trauma with accuracy comparable with that reported for triple-contrast CT.