caa a22 4500 606172203 CHVBK 20210128100727.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10140-014-1262-9 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1262-9 The utility of CT for predicting bile leaks in hepatic trauma [Elektronische Daten] [Christina LeBedis, Stephan Anderson, Gustavo Mercier, Steven Kussman, Stephanie Coleman, Louis Golden, David Penn, Jennifer Uyeda, Jorge Soto] The purpose of this study was to determine the efficacy of CT to predict the development of bile leaks in hepatic trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients who sustained hepatic trauma between January 1, 2006, and January 31, 2012, and who underwent CT and hepatobiliary scans during the same hospital admission were included. One hundred and thirty-two patients met the inclusion criteria. Comparison between the presence of biliary injury relative to American Association for the Surgery of Trauma (AAST) hepatic injury grade and mean distance of the hepatic laceration to the inferior vena cava (IVC) was made. The ability of free fluid to predict bile injury was analyzed. Forty-one (31%) of the 132 patients had positive hepatobiliary scans. Of these 41 patients, seven (17%) sustained low-grade and 34 (83%) sustained high-grade hepatic injury compared with the 37 (41%) low-grade and 54 (59%) high-grade hepatic injuries in the negative hepatobiliary scan group. The mean distance to the IVC was 2.4cm (SD 2.9cm) and 3.6cm (SD 3.3cm) in patients with and without bile leaks, respectively. A statistically significant difference in the proportion of high-grade injuries and the mean distance from the IVC between the two groups was identified. The presence of free fluid on CT is sensitive, but not specific, for detecting a bile leak. CT findings, including AAST liver injury grade and location of the liver laceration, are able to predict which patients are at risk for developing bile leaks as seen on hepatobiliary scintigraphy, whereas the presence of free fluid is not. American Society of Emergency Radiology, 2014 Hepatobiliary trauma nationallicence Bile leak nationallicence Liver laceration nationallicence CT nationallicence LeBedis Christina Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Anderson Stephan Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Mercier Gustavo Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Kussman Steven Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Coleman Stephanie Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Golden Louis Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Penn David Department of Radiology, Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road NE, Suite AG05, 30322, Atlanta, GA, USA aut Uyeda Jennifer Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, 02114, Boston, MA, USA aut Soto Jorge Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut Emergency Radiology Springer Berlin Heidelberg 22/2(2015-04-01), 101-107 1070-3004 22:2<101 2015 22 10140 https://doi.org/10.1007/s10140-014-1262-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1262-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- LeBedis Christina Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Anderson Stephan Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Mercier Gustavo Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Kussman Steven Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Coleman Stephanie Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Golden Louis Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Penn David Department of Radiology, Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road NE, Suite AG05, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Uyeda Jennifer Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Soto Jorge Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 820 Harrison Ave, 02118, Boston, MA, USA aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/2(2015-04-01), 101-107 1070-3004 22:2<101 2015 22 10140