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September 1991

A Prospective, Randomized Comparison of Computed Tomography With Conventional Diagnostic Methods in the Evaluation of Penetrating Injuries to the Back and Flank

Author Affiliations

From the Departments of Surgery (Dr Easter) and Radiology (Dr Mattrey), University of California, San Diego, Medical Center, and the Department of Surgery, University of Vermont, Burlington (Dr Shackford).

Arch Surg. 1991;126(9):1115-1119. doi:10.1001/archsurg.1991.01410330073011

• We prospectively compared computed tomography with conventional diagnostic methods in the evaluation of penetrating injuries to the back and flank in 85 patients. Immediate laparotomy was performed in 24 patients because of physical findings, and these patients were not randomized. Nine unnecessary operations were performed in this group, and these nine patients had significantly higher hospital costs than patients in either randomized group. In the randomized patients, there were only three true-positive and three false-positive findings. Both computed tomographic evaluation (31 patients) and conventional evaluation (30 patients) were highly accurate and specific for injuries that required operation. Evaluation with computed tomography required a longer time to make a hospital disposition but required fewer diagnostic tests. Computed tomography can be useful in the assessment of penetrating injuries to the back and flank.

(Arch Surg. 1991;126:1115-1119)