ACR Appropriateness Criteria® Penetrating Trauma-Lower Abdomen and Pelvis.
Published
Journal Article (Review)
Lower urinary tract injury is most commonly the result of blunt trauma but can also result from penetrating or iatrogenic trauma. Clinical findings in patients with a mechanism of penetrating trauma to the lower urinary tract include lacerations or puncture wounds of the pelvis, perineum, buttocks, or genitalia, as well as gross hematuria or inability to void. CT cystography or fluoroscopy retrograde cystography are usually the most appropriate initial imaging procedures in patients with a mechanism of penetrating trauma to the lower urinary tract. CT of the pelvis with intravenous contrast, pelvic radiography, fluoroscopic retrograde urethrography, and CT of the pelvis without intravenous contrast may be appropriate in some cases. Arteriography, radiographic intravenous urography, CT of the pelvis without and with intravenous contrast, ultrasound, MRI, and nuclear scintigraphy are usually not appropriate. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Full Text
Duke Authors
Cited Authors
- Expert Panel on Urological Imaging, ; Heller, MT; Oto, A; Allen, BC; Akin, O; Alexander, LF; Chong, J; Froemming, AT; Fulgham, PF; Mackenzie, DC; Maranchie, JK; Mody, RN; Patel, BN; Schieda, N; Turkbey, IB; Venkatesan, AM; Wang, CL; Lockhart, ME
Published Date
- November 2019
Published In
Volume / Issue
- 16 / 11S
Start / End Page
- S392 - S398
PubMed ID
- 31685107
Pubmed Central ID
- 31685107
Electronic International Standard Serial Number (EISSN)
- 1558-349X
Digital Object Identifier (DOI)
- 10.1016/j.jacr.2019.05.023
Language
- eng
Conference Location
- United States