Abdominal Seatbelt Signs – The Predictive Value of CT Free Fluid in Determining the Need for Surgery
Location
LSU Health Sciences Center - New Orleans
Event Website
https://www.medschool.lsuhsc.edu/genetics/2023_medical_student_research_poster_symposium.aspx
Presentation Date
23-10-2023 8:30 AM
Description
Background: Seatbelt-associated trauma can lead to unique injury presentations, including hollow viscus injury, which can be challenging to detect with imaging modalities. This study aims to evaluate the prevalence of intra-abdominal injuries in motor vehicle collision (MVC) patients with abdominal seatbelt signs, as well as the prevalence of intestinal injuries and delayed presentation of such injuries. Thereby, this will allow us to determine the predictive value of CT findings when taken in addition to this physical exam finding and help to refine clinical management guidelines.
Methods: A retrospective chart review was conducted in an adult level 1 Trauma Center from February 2018 to May 2021. Information was gathered from electronic medical records of adult trauma patients with a documented physical exam finding of an abdominal seatbelt sign upon presentation. These patients were broken into 2 groups: those who underwent abdominal surgery (ABD SURG) and those that did not undergo any surgery (NO SURG). Univariate analysis was then performed using Fisher’s exact test for categorical variables and a student’s ttest for continuous variables.
Results: 258 patients presenting after an MVC were documented to have an abdominal seatbelt sign and were included in our study. The ABD SURG group comprised 24 of the 258 patients (9.2%), with 22 of the 24 patients (92%) found to have either a small bowel injury, large bowel injury, mesenteric injury, or some combination of these. CT free fluid was seen in 24 of the 210 (11%) of those patients in the NO SURG group. A CT scan showed free fluid in 20 of the 24 (83%) in the ABD SURG group, which was statistically significant in comparison to the NO SURG cohort (P
Conclusion: The findings in this study show abdominal seatbelt sign patients without evidence of CT free fluid, in an otherwise negative CT, may be safely discharged without surgical intervention. Further studies can be added to strengthen these findings and help to refine existing guidelines for managing this specific cohort of trauma patients.
Recommended Citation
Leoni, Jack A., "Abdominal Seatbelt Signs – The Predictive Value of CT Free Fluid in Determining the Need for Surgery" (2023). Medical Student Research Poster Symposium. 63.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/63
Included in
Abdominal Seatbelt Signs – The Predictive Value of CT Free Fluid in Determining the Need for Surgery
LSU Health Sciences Center - New Orleans
Background: Seatbelt-associated trauma can lead to unique injury presentations, including hollow viscus injury, which can be challenging to detect with imaging modalities. This study aims to evaluate the prevalence of intra-abdominal injuries in motor vehicle collision (MVC) patients with abdominal seatbelt signs, as well as the prevalence of intestinal injuries and delayed presentation of such injuries. Thereby, this will allow us to determine the predictive value of CT findings when taken in addition to this physical exam finding and help to refine clinical management guidelines.
Methods: A retrospective chart review was conducted in an adult level 1 Trauma Center from February 2018 to May 2021. Information was gathered from electronic medical records of adult trauma patients with a documented physical exam finding of an abdominal seatbelt sign upon presentation. These patients were broken into 2 groups: those who underwent abdominal surgery (ABD SURG) and those that did not undergo any surgery (NO SURG). Univariate analysis was then performed using Fisher’s exact test for categorical variables and a student’s ttest for continuous variables.
Results: 258 patients presenting after an MVC were documented to have an abdominal seatbelt sign and were included in our study. The ABD SURG group comprised 24 of the 258 patients (9.2%), with 22 of the 24 patients (92%) found to have either a small bowel injury, large bowel injury, mesenteric injury, or some combination of these. CT free fluid was seen in 24 of the 210 (11%) of those patients in the NO SURG group. A CT scan showed free fluid in 20 of the 24 (83%) in the ABD SURG group, which was statistically significant in comparison to the NO SURG cohort (P
Conclusion: The findings in this study show abdominal seatbelt sign patients without evidence of CT free fluid, in an otherwise negative CT, may be safely discharged without surgical intervention. Further studies can be added to strengthen these findings and help to refine existing guidelines for managing this specific cohort of trauma patients.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/63
Comments
Mentor: Dr. Alison A. Smith LSUHSC, Department of Surgery