PMID- 29484462
OWN - NLM
STAT- MEDLINE
DCOM- 20200103
LR  - 20200225
IS  - 1863-9941 (Electronic)
IS  - 1863-9933 (Linking)
VI  - 45
IP  - 3
DP  - 2019 Jun
TI  - Accuracy of CT chest without oral contrast for ruling out esophageal perforation 
      using fluoroscopic esophagography as reference standard: a retrospective study.
PG  - 517-525
LID - 10.1007/s00068-018-0929-4 [doi]
AB  - PURPOSE: Esophageal perforation has a high mortality rate. Fluoroscopic 
      esophagography (FE) is the procedure of choice for diagnosing esophageal 
      perforation. However, FE can be difficult to perform in seriously ill patients. 
      METHODS: We retrospectively reviewed charts and scans of all patients who had 
      undergone thoracic CT (TCT) without oral contrast and FE for suspicion of 
      esophageal perforation at our hospital between October, 2010 and December, 2015. 
      Scans were interpreted by a single consultant radiologist having > 5 years of 
      relevant experience. Statistical analysis was performed using SPSS version 20. 
      Sensitivity, specificity, positive predictive value (PPV) and negative predictive 
      value (NPV) of TCT were computed using FE as reference standard. RESULTS: Of 122 
      subjects, 106 (83%) were male and their median age was 42 [inter-quartile range 
      (IQR) 29-53] years. Esophageal perforation was evident on FE in 15 (8%) cases. 
      Sensitivity, specificity, PPV and NPV of TCT for detecting esophageal perforation 
      were 100, 54.6, 23.4 and 100%, respectively. When TCT was negative (n = 107), an 
      alternative diagnosis was evident in 65 cases. CONCLUSION: Thoracic computed 
      tomography (TCT) had 100% sensitivity and negative predictive value for excluding 
      esophageal perforation. FE may be omitted in patients who have no evidence of 
      mediastinal collection, pneumomediastinum or esophageal wall defect on TCT. 
      However, in the presence of any of these features, FE is still necessary to 
      confirm or exclude the presence of an esophageal perforation.
FAU - Awais, Muhammad
AU  - Awais M
AUID- ORCID: 0000-0003-2170-5344
AD  - Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium 
      Road, Karachi, Sindh, 74800, Pakistan. awais_aku@yahoo.com.
AD  - Department of Radiology, Dow University of Health Sciences, Ojha Campus, Suparco 
      Road, KDA Scheme 33, Karachi, Sindh, 75270, Pakistan. awais_aku@yahoo.com.
FAU - Qamar, Saqib
AU  - Qamar S
AD  - Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium 
      Road, Karachi, Sindh, 74800, Pakistan.
FAU - Rehman, Abdul
AU  - Rehman A
AUID- ORCID: 0000-0002-8398-7810
AD  - Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium 
      Road, Karachi, Sindh, 74800, Pakistan.
AD  - Internal Medicine Section, Department of Medicine, Hamad Medical Corporation, 
      P.O. box 3050, Doha, Qatar.
FAU - Baloch, Noor Ul-Ain
AU  - Baloch NU
AUID- ORCID: 0000-0002-0250-3504
AD  - Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium 
      Road, Karachi, Sindh, 74800, Pakistan.
AD  - Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.
FAU - Shafqat, Gulnaz
AU  - Shafqat G
AD  - Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium 
      Road, Karachi, Sindh, 74800, Pakistan.
LA  - eng
PT  - Journal Article
DEP - 20180226
PL  - Germany
TA  - Eur J Trauma Emerg Surg
JT  - European journal of trauma and emergency surgery : official publication of the 
      European Trauma Society
JID - 101313350
RN  - 0 (Contrast Media)
SB  - IM
MH  - Accidents, Traffic
MH  - Adult
MH  - Contrast Media
MH  - Esophageal Perforation/complications/*diagnostic imaging
MH  - Esophagus/*diagnostic imaging/injuries
MH  - Extravasation of Diagnostic and Therapeutic Materials/*diagnostic 
      imaging/etiology
MH  - Female
MH  - Fluoroscopy
MH  - Humans
MH  - Male
MH  - Mediastinal Emphysema/diagnostic imaging/etiology
MH  - Middle Aged
MH  - Postoperative Complications/*diagnostic imaging/etiology
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Thoracic Injuries/complications/*diagnostic imaging
MH  - Tomography, X-Ray Computed
MH  - Wounds, Gunshot/complications/*diagnostic imaging
OTO - NOTNLM
OT  - Computed tomography
OT  - Contrast swallow
OT  - Esophageal perforation
OT  - Esophagography
OT  - Fluoroscopy
EDAT- 2018/02/28 06:00
MHDA- 2020/01/04 06:00
CRDT- 2018/02/28 06:00
PHST- 2017/11/13 00:00 [received]
PHST- 2018/02/23 00:00 [accepted]
PHST- 2018/02/28 06:00 [pubmed]
PHST- 2020/01/04 06:00 [medline]
PHST- 2018/02/28 06:00 [entrez]
AID - 10.1007/s00068-018-0929-4 [pii]
AID - 10.1007/s00068-018-0929-4 [doi]
PST - ppublish
SO  - Eur J Trauma Emerg Surg. 2019 Jun;45(3):517-525. doi: 10.1007/s00068-018-0929-4. 
      Epub 2018 Feb 26.