Quiñones A, Basilio A, Delgadillo S

Language: Spanish
References: 31
Page: 89-96
PDF size: 99.81 Kb.

ABSTRACT

Small bowel injuries can be very difficult to diagnose because the actual studies have limitations. Abdominal Plain radiographs have very low sensitivity, and have high false negatives, so it’s not the ideal study to diagnose small bowel injuries. The diagnostic peritoneal lavage is a quick method, with high sensitivity and specificity, despite the fact that it’s safe, cheap, and the results can be interpreted easily, it’s invasive, doesn’t specify the injured organ or retroperitoneal injuries, so it’s use is becoming to decline. The computed tomography has been very effective to diagnose solid organ injuries, hemoperitoneum, or retroperitoneum, but ineffective for diaphragmatic, pancreatic or hollow viscus injuries; actually is the most primary diagnostic modality used in stable patients. The multiple slice computed tomography is a useful option, because images can be done in less time and obtain better details, and diagnostic capacity. Abdominal ultrasound or FAST, is the study of choice in unstable patients. It has the limitation of diagnose retroperitoneal injuries; it is a non-invasive study, and detects rapidly free intraperitoneal fluid, and has no complications. The utility of the diagnostic laparoscopy is still in development. The nuclear medicine has an important utility to exclude hollow viscus injuries, but its use is limited, because the patients have to be selected carefully.

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