{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T16:56:48Z","timestamp":1761843408364},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T00:00:00Z","timestamp":1214611200000},"content-version":"vor","delay-in-days":1062,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:bold>Objectives:<\/jats:bold> To evaluate the utility of routine abdominal computed tomographic (CT) scanning for abdominal evaluation of blunt trauma patients before urgent extra\u2010abdominal surgery. <jats:bold>Methods:<\/jats:bold> In this observational cohort study, we prospectively enrolled all blunt trauma patients at least 8 years of age presenting to the emergency department of a Level 1 trauma center who were initially considered to require urgent extra\u2010abdominal surgery within 24 hours of presentation. Patients were excluded if they had any of the following: 1) isolated extremity trauma, 2) signs or symptoms of intra\u2010abdominal injury (including systolic blood pressure &lt;90 mm Hg; abdominal, flank, or costal margin tenderness; abdominal wall contusion or abrasion; pelvic fracture; and gross hematuria), or 3) unreliable findings on abdominal examination (Glasgow Coma Scale score &lt;14, paralysis, or mental retardation). Clinical data were documented on a data sheet before abdominal CT scanning. <jats:bold>Results:<\/jats:bold> A total of 254 patients, with a mean (\u00b1SD) age of 32.3 (\u00b116.1) years, were enrolled. A total of 201 patients ultimately underwent urgent extra\u2010abdominal surgery for the following procedures: orthopedic, 182 (91%); facial, 17 (8%); laceration, 7 (3%); vascular, 6 (2%); neurosurgical, 3 (1%); urology, 2 (1%); and ophthalmology, 1 (0.4%). Three patients (1.2%; 95% confidence interval = 0.2% to 3.4%) were found to have intra\u2010abdominal injuries. Two patients had splenic injuries that required only observation. One patient (0.4%; 95% confidence interval = 0% to 2.2%) underwent laparotomy. This patient sustained multiple injuries in a motorcycle crash, including splenic, kidney, and pancreatic injuries, and underwent a splenectomy. <jats:bold>Conclusions:<\/jats:bold> Abdominal CT scanning has a low yield in trauma patients whose sole indication for diagnostic abdominal evaluation is the need for general anesthesia for urgent extra\u2010abdominal surgery. A small percentage of these patients, however, will have important intra\u2010abdominal injuries such that further refinement of the recommendations for diagnostic study in this select population is needed.<\/jats:p>","DOI":"10.1197\/j.aem.2005.03.523","type":"journal-article","created":{"date-parts":[[2005,8,3]],"date-time":"2005-08-03T23:47:39Z","timestamp":1123112859000},"page":"707-711","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is Definitive Abdominal Evaluation Required in Blunt Trauma Victims Undergoing Urgent Extra\u2010abdominal Surgery?"],"prefix":"10.1111","volume":"12","author":[{"given":"James F.","family":"Holmes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bobbie Ann","family":"Schauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hien","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Wisner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,6,28]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"American College of Surgeons Committee on Trauma Advanced Trauma Life Support for Doctors.","year":"1997"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200008000-00004"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000147518.96480.B3"},{"key":"e_1_2_1_5_1","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1097\/00005373-198912000-00013","article-title":"Organ injury scaling: spleen, liver, and kidney.","volume":"29","author":"Moore EE","year":"1989","journal-title":"J Trauma."},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199503000-00001"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(98)80099-8"},{"key":"e_1_2_1_8_1","first-page":"794","article-title":"The complementary roles of diagnostic peritoneal lavage and computed tomography in the evaluation of blunt abdominal trauma.","volume":"106","author":"Sorkey AJ","year":"1989","journal-title":"Surgery."},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(97)70343-3"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.145.6.1191"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199209000-00009"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197606000-00009"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.122900"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1989.01410070063013"},{"key":"e_1_2_1_15_1","first-page":"457","article-title":"Recognition of intra\u2010abdominal injury in blunt trauma victims. A prospective study comparing physical examination with peritoneal lavage.","volume":"48","author":"Rodriguez A","year":"1982","journal-title":"Am Surg."},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(98)90032-8"},{"key":"e_1_2_1_17_1","first-page":"834","article-title":"[Concomitant intra\u2010abdominal injuries in pelvic trauma].","volume":"110","author":"Pajenda GS","year":"1998","journal-title":"Wien Klin Wochenschr."},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200104000-00015"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199505000-00008"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01197-3"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199903000-00006"},{"key":"e_1_2_1_22_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/000313489906500108","article-title":"Increased efficiency and cost\u2010effectiveness in the evaluation of the blunt abdominal trauma patient with the use of ultrasound.","volume":"65","author":"Arrillaga A","year":"1999","journal-title":"Am Surg."},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199606000-00003"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200101000-00019"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199308000-00016"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199506000-00009"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.170.4.9580140"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01777.x"},{"key":"e_1_2_1_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.35458"},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199704000-00006"},{"key":"e_1_2_1_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200009000-00019"},{"key":"e_1_2_1_32_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.212.2.r99au18423"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1197%2Fj.aem.2005.03.523","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1197\/j.aem.2005.03.523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T04:41:43Z","timestamp":1695962503000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1197\/j.aem.2005.03.523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,8]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2005,8]]}},"alternative-id":["10.1197\/j.aem.2005.03.523"],"URL":"https:\/\/doi.org\/10.1197\/j.aem.2005.03.523","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8]]},"assertion":[{"value":"2008-06-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}