Comment on “What is the diagnostic value of computed tomography tractography in patients with abdominal stab wounds?”

KB Yilmaz, M Akinci, S Tamam, S Tokgoz… - European Journal of …, 2017 - Springer
KB Yilmaz, M Akinci, S Tamam, S Tokgoz, S Balas, M Akkoca, H Karabacak
European Journal of Trauma and Emergency Surgery, 2017Springer
In our clinical practice, we also use the CT tractography in the same way as Uzunosmanoğlu
et al.[1]. However, we are aware that both stab wounds and tractography techniques are
painful for the patients despite local anesthesia. In some patients, pain results in muscular
rigidity which may block the contrast agent's passage and it may lead to false negative
results. Besides, small stab wounds, diagonal stab tract, heavy musculature, and increased
body mass index are also factors that may create diagnostic dilemma. Under the influence of …
In our clinical practice, we also use the CT tractography in the same way as Uzunosmanoğlu et al.[1]. However, we are aware that both stab wounds and tractography techniques are painful for the patients despite local anesthesia. In some patients, pain results in muscular rigidity which may block the contrast agent’s passage and it may lead to false negative results. Besides, small stab wounds, diagonal stab tract, heavy musculature, and increased body mass index are also factors that may create diagnostic dilemma. Under the influence of alcohol and stimulants, these techniques may become more problematic for the clinicians due to the lack of patient cooperation. Herein we would like to report a 39-year-old male patient’s CT tractography figure, in which the distribution of the contrast agent was limited and the contrast did not spread into intraperitoneal space (Fig. 1). In that hemodynamically stabile patient, gastric stab wound injury was missed with only CT tractography. In another patient—a 26-year-old male—with stab wounds, CT tractography was
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