Title: CT Tractography as a last option for penetrating abdominal wall injuries with equivocal contrast CT finding.

Biography:

Abstract

Although there are different techniques to detect peritoneal violation in penetrating anterior abdominal wall injuries like local wound exploration (LWE), serial abdominal examination (SAE), computed tomography (CT) and diagnostic laparoscopy (DL) , none has been considered standard (1).

Even in the most recent guideline algorithm by Western Trauma Association (WTA), AASW management diverges into three equivalent options, namely CT evaluation, LWE and SAE (2). SAE is reliable in detecting significant injuries. However, it requires to be performed by experienced clinicians and preferably by the same team. Also, it risks the morbidity of delaying a therapeutic intervention.

Recently, CT was introduced in the management of penetrating abdominal trauma. It should be noted that two distinct types of CT are now being used; CT with oral and IV contrast and CT tractography—which is a CT of the abdominal stab wound tract performed using water-soluble contrast agent. (3) However, there is much debate in the literature regarding the utility of CT in anterior abdominal wall injuries.(5)