A prospective, randomized comparison of computed tomography with conventional diagnostic methods in the evaluation of penetrating injuries to the back and flank
D. W. Easter, S. R. Shackford and R. F. Mattrey
Department of Surgery University of California, San Diego.
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.
