Nasogastric Tube as a Diagnostic Tool for Gastric Injury in Penetrating Abdominal Trauma

MEDICINE Research project

To evaluate the role of nasogatric tube placement in the diagnosis of gastric injury in penetrating abdominal trauma in adults. STUDY DESIGN: This is a prospective study to assess the diagnostic accuracy of NGT in gastric injury from penetrating abdominal trauma. All patients suspected with penetrating abdominal injury in FEU-NRMF Medical Center from January 2006 to June 2007 were inserted with nasogastric tube to assess the status of the stomach. Pediatric patients were excluded. A positive result was considered if bloody aspirate was noted from NGT. Gastric injury was confirmed by direct inspection through laparotomy and by serial physical examination if laparotomy was not performed. RESULTS: A total of 99 patients were susptected to have penetrating abdominal injury and 91 patients (89 males and 2 females) were eligible for the study. The mean age was 31.25 + 8.72 years. Fifteen were confirmed to have gastric injury and 14 (93.3%) were detected by NGT. One patient had positive NGT finding with no gastric injury but laparotomy revealed penetrating trauma to the duodenum. The overall sensitivity was 93.33 % with a specificity of 98.68 %, positive predictive value of 93.33% and negative predictive value of 98.68% CONCLUSION: Nasogastric tube is a viable tool to diagnose the presence of gastric injury in penetrating abdominal trauma with an accuracy rate of 97.8% and is not affected by the type of trauma. Possible additional benefit of NGT is to assess the proximal part of the small intestine for injury. It may be a diagnostic option for initial assessment in trauma centers as well as in rural hospitals.