CT Tractography as a last option for penetrating abdominal wall injuries with equivocal contrast CT findings: A proposed diagnostic approach

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Abstract Background CT tractography is a potential approach in which a CT is conducted after an entire stab wound tract is filled with a water-soluble contrast agent in patients with abdominal stab wounds. The goal of this study is to evaluate the effectiveness of using CT tractography as an option in the management of penetrating abdominal trauma. Does CT Tractography function as a useful technique for assessing patients with Anterior Abdominal Stab Wounds (AASW)? Patients and Methods The study included 82 patients admitted to the trauma center at Alexandria Main University Hospital in Egypt who had penetrating anterior abdominal wall injuries, were in stable condition, and had a contrast CT scan of the abdomen and pelvis that was inconclusive about peritoneal penetration. Results A total of 57 patients underwent exploration after showing positive findings of contrast leak into the peritoneal cavity. 25 patients with CT Tractography results that demonstrated no leak into the peritoneal cavity were treated conservatively without the necessity for surgical intervention. Conclusion In the study, CT tractography correctly identified 100% of the patients who needed laparotomies, and none of the patients without peritoneal penetration required surgical intervention during follow-up. The examination of patients with AASW can be done efficiently by CT tractography.

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