Is computed tomography cystography indicated in children with pelvic fractures?

作     者：Alexander Becker Ori Yaslowitz Joseph Dubose Kobi Peleg Yaakov Daskal Adi Givon Israel Trauma Group Boris Kessel Becker Alexander;Yaslowitz Ori;Dubose Joseph;Peleg Kobi;Daskal Yaakov;Givon Adi;Group Israel Trauma;Kessel Boris

作者机构：Department of SurgeryEmek Medical Center.AfulaIsrael The Rappoport School of MedicineTechnionHaifaIsrael Department of Surgery AMeir Medical CenterKfar-SabaIsrael R Adams Cowley Shock Trauma CenterUniversity of Maryland Medical SystemBaltimoreMDUSA National Center for Trauma and Emergency Medicine ResearchGertner Institute for Epidemiology and Health Policy ResearchTel HashomerIsrael Emergency and Disaster Management DepartmentFaculty of Medicine.School of Public Health.Tel-Aviv UniversityIsrael Trauma UnitHillel Yaffe Medical CenterHaderaIsrael 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2020年第23卷第3期

页      面：181-184页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1006[医学-中西医结合] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100202[医学-儿科学] 100106[医学-放射医学] 100602[医学-中西医结合临床] 10[医学] 

主　　题：Tomography,X-ray computed Cystography Bladder injury Child Pelvic fracture 

摘      要：Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional ***: A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chisquare test and two-sided Fisher’s exact test. Ap value of less than 0.05 was considered statistically ***: A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).Conclusion: The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population.