Imaging the oesophagus after penetrating cervical trauma using water-soluble contrast alone: Simple, cost-effective and accurate

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dc.contributor.authorNel L.
dc.contributor.authorWhitfield Jones L.
dc.contributor.authorHardcastle T.C.
dc.date.accessioned2011-05-15T16:16:17Z
dc.date.available2011-05-15T16:16:17Z
dc.date.issued2009
dc.description.abstractAim: This audit aims to gauge the safety and efficacy of iso-oncotic water-soluble contrast media as the sole imaging evaluation of the distal pharynx and cervical oesophagus after penetrating cervical trauma. Methods: A retrospective audit was performed over a 4-year period of all patients with penetrating cervical trauma to zones 1 and 2 of the neck who were subjected to imaging evaluation as part of a selective non-operative management policy for penetrating cervical trauma. The outcome was reviewed and the sensitivity, specificity and predictive values of the investigation were determined. The surgical management of identified injuries is also described. Results: Four hundred and sixty-five contrast studies were included with 11 studies positive for pathology (9 injuries, 2 incidental findings). Surgery was undertaken in 4 patients with cervical oesophageal injuries and conservative management was carried out in 5 cases of distal pharyngeal injury. No missed injuries and no significant adverse events were identified during the study period. Conclusion: A contrast study of the oesophagus with water-soluble iso-oncotic contrast media as the sole diagnostic imaging modality is safe (avoiding the risk of aspiration pneumonia), reliable (identifying all injuries) and cost-efficient (avoiding the need for additional expensive investigations) in cases of penetrating cervical trauma.
dc.description.versionArticle
dc.identifier.citationEmergency Medicine Journal
dc.identifier.citation26
dc.identifier.citation2
dc.identifier.issn14720205
dc.identifier.other10.1136/emj.2008.063958
dc.identifier.urihttp://hdl.handle.net/10019.1/13714
dc.subjectcontrast medium
dc.subjectunclassified drug
dc.subjectwater soluble contrast
dc.subjectarticle
dc.subjectcervical spine injury
dc.subjectconservative treatment
dc.subjectcost effectiveness analysis
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic imaging
dc.subjectesophagus
dc.subjecthealth care policy
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectneck
dc.subjectpenetrating trauma
dc.subjectpharynx
dc.subjectprediction and forecasting
dc.subjectpriority journal
dc.subjectreliability
dc.subjectretrospective study
dc.subjectrisk assessment
dc.subjectsensitivity and specificity
dc.subjectContrast Media
dc.subjectCost-Benefit Analysis
dc.subjectEsophagus
dc.subjectFalse Negative Reactions
dc.subjectHumans
dc.subjectIncidental Findings
dc.subjectIohexol
dc.subjectMedical Audit
dc.subjectPharynx
dc.subjectRetrospective Studies
dc.subjectWounds, Penetrating
dc.titleImaging the oesophagus after penetrating cervical trauma using water-soluble contrast alone: Simple, cost-effective and accurate
dc.typeArticle
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