Adela Golea1*, Raluca Tat1, Eugenia Maria Lupan1, Nadim Al Hajar2, Radu Badea3 and Simona Mărgărit4
1Department of Emergency Medicine, University of Medicine and Pharmacy, Romania
2Department of Surgery, University of Medicine and Pharmacy, Romania
3Department of Ultrasound, University of Medicine and Pharmacy, Romania
4Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy, Romania
The pandemic period, in which patients with liver tumor pathology presented in the emergency department for various acute febrile conditions, exposes them to numerous irradiating examinations for diagnosis purposes. The large number of imagistic investigations performed in the emergency departments due to the agglomeration of cases during the pandemic, increases the waiting time until an abdominal computer tomography is performed and the result is obtained. Understanding the parenchymal structural changes caused by the use of coagulation necrosis provides pathophysiological support for the interpretation of changes observed in postoperative ultrasonographic examination and the differentiation of residual scar aspects from other complications and reduces the number of exposures to high class imagistic investigations. There were selected, in this retrospective study, 82 patients examined in the Ultrasonography Department with liver tumor. In case of 49 (59.75%) patients are opted for the coagulation necrosis technique only, with intraoperative ultrasound guidance and CT confirmation of the postoperative ultrasonographic aspects. Only 40 (48.78%) patients had an evolution without complication or tumor recurrence and remain on study evaluation, 32 (39.02%) of patients with lesion under 4cm from selected patients develop scar with immobile air artifacts ultrasound aspect. The analysis of the selected image library allowed the description of the evolution of the postoperative ultrasonographic changes at 3/6/9 months. The description of an examination algorithm based on the ultrasonographic aspects identified in the imaging database of an expert center can be a diagnostic support tool for emergency physicians, for the purpose of a rapid exclusion rule (rule-out for CT scan) and reducing the number of emergency CT scans.
Golea A, Tat R, Lupan EM, Al Hajar N, Badea R, Mărgărit S. The Library of Images, an Instrument for Rule Out CT Scan in the Emergency Department, During COVID Times, in Patients with Liver Resections Using Coagulation Necrosis. Clin Surg. 2021; 6: 3351..