The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis

Traumatic bowel mesenteric injury (TBMI) is a challenge in trauma care. The presence of free peritoneal fluid (FF) in computed tomography (CT) was considered the indication for surgical intervention. However, conservative treatment should be applied for minor injuries. We conduct a systematic review...

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Autores principales:	Szu-An Chen, Chen-Yu Wang, Chih-Po Hsu, Jia-Yen Lin, Chi-Tung Cheng, Chun-Hsiang Ouyang, Jen-Fu Huang, Chien-Hung Liao
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	traumatic bowel and mesenteric injury computed tomography free peritoneal fluid systematic review Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/bc6dfb158c6441a3be297e780c5f3ad2
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spelling	oai:doaj.org-article:bc6dfb158c6441a3be297e780c5f3ad22021-11-25T17:20:56ZThe Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis10.3390/diagnostics111120282075-4418https://doaj.org/article/bc6dfb158c6441a3be297e780c5f3ad22021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2028https://doaj.org/toc/2075-4418Traumatic bowel mesenteric injury (TBMI) is a challenge in trauma care. The presence of free peritoneal fluid (FF) in computed tomography (CT) was considered the indication for surgical intervention. However, conservative treatment should be applied for minor injuries. We conduct a systematic review to analyze how reliable the FF is to assess the TBMI. Publications were retrieved by structured searching among databases, review articles and major textbooks. For statistical analysis, summary receiver operating characteristic curves (SROCs) were computed using hierarchical models. Fourteen studies enrolling 4336 patients were eligible for final qualitative analysis. The SROC line was created by a hierarchical summary receiver operating characteristic model. The summary sensitivity of FF to predict surgical TBMI was 0.793 (95% CI: 0.635–0.894), and the summary specificity of FF to predict surgical TBMI was 0.733 (95% CI: 0.468–0.896). The diagnostic odds ratio was 10.531 (95% CI: 5.556–19.961). This study represents the most robust evidence (level 3a) to date that FF is not the absolute but an acceptable indicator for surgically important TBMI. However, there is still a need for randomized controlled trials to confirm.Szu-An ChenChen-Yu WangChih-Po HsuJia-Yen LinChi-Tung ChengChun-Hsiang OuyangJen-Fu HuangChien-Hung LiaoMDPI AGarticletraumatic bowel and mesenteric injurycomputed tomographyfree peritoneal fluidsystematic reviewMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2028, p 2028 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	traumatic bowel and mesenteric injury computed tomography free peritoneal fluid systematic review Medicine (General) R5-920
spellingShingle	traumatic bowel and mesenteric injury computed tomography free peritoneal fluid systematic review Medicine (General) R5-920 Szu-An Chen Chen-Yu Wang Chih-Po Hsu Jia-Yen Lin Chi-Tung Cheng Chun-Hsiang Ouyang Jen-Fu Huang Chien-Hung Liao The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
description	Traumatic bowel mesenteric injury (TBMI) is a challenge in trauma care. The presence of free peritoneal fluid (FF) in computed tomography (CT) was considered the indication for surgical intervention. However, conservative treatment should be applied for minor injuries. We conduct a systematic review to analyze how reliable the FF is to assess the TBMI. Publications were retrieved by structured searching among databases, review articles and major textbooks. For statistical analysis, summary receiver operating characteristic curves (SROCs) were computed using hierarchical models. Fourteen studies enrolling 4336 patients were eligible for final qualitative analysis. The SROC line was created by a hierarchical summary receiver operating characteristic model. The summary sensitivity of FF to predict surgical TBMI was 0.793 (95% CI: 0.635–0.894), and the summary specificity of FF to predict surgical TBMI was 0.733 (95% CI: 0.468–0.896). The diagnostic odds ratio was 10.531 (95% CI: 5.556–19.961). This study represents the most robust evidence (level 3a) to date that FF is not the absolute but an acceptable indicator for surgically important TBMI. However, there is still a need for randomized controlled trials to confirm.
format	article
author	Szu-An Chen Chen-Yu Wang Chih-Po Hsu Jia-Yen Lin Chi-Tung Cheng Chun-Hsiang Ouyang Jen-Fu Huang Chien-Hung Liao
author_facet	Szu-An Chen Chen-Yu Wang Chih-Po Hsu Jia-Yen Lin Chi-Tung Cheng Chun-Hsiang Ouyang Jen-Fu Huang Chien-Hung Liao
author_sort	Szu-An Chen
title	The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
title_short	The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
title_full	The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
title_fullStr	The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
title_full_unstemmed	The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis
title_sort	current diagnostic accuracy on free peritoneal fluid in computed tomography to determinate the necessity of surgery in blunt bowel and mesenteric trauma—systemic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/bc6dfb158c6441a3be297e780c5f3ad2
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The Current Diagnostic Accuracy on Free Peritoneal Fluid in Computed Tomography to Determinate the Necessity of Surgery in Blunt Bowel and Mesenteric Trauma—Systemic Review and Meta-Analysis

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