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Title: Evaluation of efficiency of selected diagnostic methods in abdominal injuries in trauma victims

Abstract:

Methods used in 2nd Department of Surgery UJ CM (1995 – 2004) in diagnosis of abdominal injuries were evaluated: clinical examination CE, ultrasound FAST, diagnostic peritoneal lavage DPL, computed tomography CT, laparoscopy LS and contrast studies of the urinary tract IVP. Evaluation included: sensitivity SE, specificity SP, positive PPV and negative NPV predictive values. Abdominal injuries were diagnosed in 15,5% patients. 69% were treated surgically, 28% conservatively. In 3% injuries were missed. 9% of 178 abdominal operations were exploratory laparotomies. CE was always used. For history taking SE was 67,4%, SP 69,9%, PPV 29,5%, NPV 91,9% , for physical examination 82,4%, 68,8%, 32,4%, 95,5% respectively. FAST were performed in 97,6%. SE was 91,1%, SP 97,9%, PPV 86,1%, and NPV 98,7%. DPL was performed in 3,27%. One complication of DPL was noted: laceration of mesentery with troacar. SE, SP, PPV and NPV were assessed to be 82-83%. LS was used in 3,2% of trauma victims. LS was complicated with bowel perforation once. LS proved to be effective diagnostic method in qualification for laparotomy (SE 92%, SP and PPV 100%, NPV 90%) and in making diagnosis (84%, 100%, 100%, 64%). IVP was used in 3,2% and CT in 1,92% of patients. Results. CE together with FAST allows exclude internal injuries or constitutes the initial diagnosis which should be verified with CT or LS. Therapeutic decisions can be make faster and some laparotomies can be avoided by using laparoscopy. DPL and IVP are useful in doubtful cases during surgery. Proposed algorithm allows selecting diagnostic technique on the basis of capabilities and personal experience

Level of degree:

2 - studia doktoranckie

Degree discipline:

chirurgia

Degree grantor:

Wydział Lekarski

Promoter:

Leszek Brongel

Date issued:

2007

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:1152

Call number:

ZB-105986

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Jun 24, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

6

Number of object content views in PDF format

6

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/1152

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ZB-105986 Jun 24, 2019
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