Assessment of computed tomography indications and computed tomography reports for usefulness in clinical presentation at postoperative follow-up of gunshot wound cases.

Abstract

The present study aimed to evaluate the results of lower thoracic tomography (LTT) and upper abdominal tomography (UAT) of the patients who were treated and followed at our tertiary center due to gunshot wounds (GSWs). The present research was designed as a retrospective descriptive study. All patients, who were admitted to our clinic due to GSW between January 2016 and April 2020, were retrospectively analyzed. This study included 44 patients who had postoperative lower thoracic and upper abdominal tomography scans. Among the patients, 43 (97.72%) were male, and one (2.27%) patient was female, with a mean age of 27.45 (range: 20-53) years. The mean length of hospital stay was 14.93 (range: 5-38) days. The mean number of tomography scans per patient was 1.65 (1-4), and the mean Injury Severity Score (ISS) was 24.38 (12-43). Among the patients, 31 (70.45%) had a direct GSW from a pistol or a rifle, while 13 (29.5%) sustained secondary injuries from shrapnel emanating from a bomb explosion. Furthermore, 23 (52.27%) patients who were initially operated at another center were clinically observed, while 15 (34.09%) patients were operated for the first time, and six (13.63%) patients had their second operation. LTT scans were obtained due to dyspnea, direct thoracic trauma and in addition to abdominal tomography for follow-up in 25 (56.81%), 13 (29.54%) and six (13.63%) patients, respectively. UAT scans were obtained for postoperative follow-up in 29 (65.90%), preoperative assessment in 12 (27.27%) and assessment of blast trauma in the absence of,direct abdominal trauma in three (6.81%) patients. The most common finding on LTT was effusion (47.7%). No pathology was observed in 61.36% of the UAT scans, while liver laceration was noted in 20.45%. The total cost of LTT and UAT was almost half that of a total thoracic tomography and a whole abdominal tomography. Selective lower thoracic and upper abdominal tomography obtained following a gunshot injury may be used not only to detect pathology but also as an efficacious, fast, reliable and cost-effective imaging method.