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Follow-Up Imaging in Patients with Blunt Splenic or Hepatic Injury Managed Nonoperatively.

Abstract Nonoperative management of blunt splenic and hepatic injuries has become the standard of care for hemodynamically stable patients. However, nonoperative management may lead to delayed complications and appropriate follow-up is therefore crucial. The aim of this systematic literature review was to assess the role of different imaging modalities in the follow-up assessment of patients with blunt splenic or hepatic injuries using the PubMed database. Eighteen studies were found to be relevant to the topic. A total of 2725 patients were enrolled in the included studies. Both retrospective and prospective studies, but no randomized controlled trials were found. In these studies, CT, ultrasound, and contrast-enhanced ultrasound were discussed. CT was the most commonly used imaging modality. Taking into account all studies included, only one patient underwent intervention due to a complication diagnosed by follow-up CT scan in the absence of clinical signs and symptoms. This equates to a total of 920 CT scans performed to diagnose one clinically nonevident complication that required intervention. Based on the reviewed literature, routine imaging follow-up CT scans may not be indicated in asymptomatic patients with lower grade blunt splenic or hepatic injuries. Contrast-enhanced ultrasound is a promising alternative imaging modality for the follow-up of these patients.
PMID
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Authors

Mayor MeshTerms

Aftercare

Conservative Treatment

Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 29580347
OWN - NLM
STAT- MEDLINE
DCOM- 20180404
LR  - 20180404
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 84
IP  - 2
DP  - 2018 Feb 1
TI  - Follow-Up Imaging in Patients with Blunt Splenic or Hepatic Injury Managed
      Nonoperatively.
PG  - 208-214
AB  - Nonoperative management of blunt splenic and hepatic injuries has become the
      standard of care for hemodynamically stable patients. However, nonoperative
      management may lead to delayed complications and appropriate follow-up is
      therefore crucial. The aim of this systematic literature review was to assess the
      role of different imaging modalities in the follow-up assessment of patients with
      blunt splenic or hepatic injuries using the PubMed database. Eighteen studies
      were found to be relevant to the topic. A total of 2725 patients were enrolled in
      the included studies. Both retrospective and prospective studies, but no
      randomized controlled trials were found. In these studies, CT, ultrasound, and
      contrast-enhanced ultrasound were discussed. CT was the most commonly used
      imaging modality. Taking into account all studies included, only one patient
      underwent intervention due to a complication diagnosed by follow-up CT scan in
      the absence of clinical signs and symptoms. This equates to a total of 920 CT
      scans performed to diagnose one clinically nonevident complication that required 
      intervention. Based on the reviewed literature, routine imaging follow-up CT
      scans may not be indicated in asymptomatic patients with lower grade blunt
      splenic or hepatic injuries. Contrast-enhanced ultrasound is a promising
      alternative imaging modality for the follow-up of these patients.
FAU - Mebert, R Viola
AU  - Mebert RV
FAU - Schnuriger, Beat
AU  - Schnuriger B
FAU - Candinas, Daniel
AU  - Candinas D
FAU - Haltmeier, Tobias
AU  - Haltmeier T
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - *Aftercare
MH  - *Conservative Treatment
MH  - Humans
MH  - Liver/diagnostic imaging/*injuries
MH  - Spleen/diagnostic imaging/*injuries
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Wounds, Nonpenetrating/*diagnostic imaging/*therapy
EDAT- 2018/03/28 06:00
MHDA- 2018/04/05 06:00
CRDT- 2018/03/28 06:00
PHST- 2018/03/28 06:00 [entrez]
PHST- 2018/03/28 06:00 [pubmed]
PHST- 2018/04/05 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2018 Feb 1;84(2):208-214.