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GSW to liver

khumar huseynova khumarhuse at yahoo.ca
Thu Jan 17 02:57:32 GMT 2008 

About SW to anterior abdo and mgt of a hemodynamically stable pt...
  We are currently doing a decision analysis on this. I have reviewed the literature and there are basically no clearcut guidelines as far as the management. For example, some centers elect to observe omental evisceration. Some decide to scan them. With observation of stable pts, the rprobability of negative laparptomy is about 0.2. CT on average has a sensitivity of 90%, specificity of 75% and a NPV of 98%. Based on our prelim analysis, CT has no advantage in terms of preventing complications (all kinds of) and observation fairs better. In general, CT gives higer FN rates for diaphragmatic and viscus injuries. Hospital stay is definitely shorter with observation. Again, we are talking about a stable pt w SWAAbdo.
  KH

       
 
              
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