Evaluation of Bowel and Mesentery in Abdominal Trauma (original) (raw)
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Computed tomography (CT) of bowel and mesenteric injury in blunt abdominal trauma: a pictorial essay
The Medical journal of Malaysia, 2012
Computed tomography (CT) is currently the diagnostic modality of choice in the evaluation of clinically stable patients with blunt abdominal trauma, including the assessment of blunt bowel and mesenteric injuries. CT signs of bowel and/or mesenteric injuries are bowel wall defect, free air, oral contrast material extravasation, extravasation of contrast material from mesenteric vessels, mesenteric vascular beading, abrupt termination of mesenteric vessels, focal bowel wall thickening, mesenteric fat stranding, mesenteric haematoma and intraperitoneal or retroperitoneal fluid. This pictorial essay illustrates CT features of bowel and/or mesenteric injuries in patients with blunt abdominal trauma. Pitfalls in interpretation of images are emphasized in proven cases.
Turkish Journal of Trauma and Emergency Surgery, 2014
BACKGROUND: The purpose of this study was to investigate the diagnostic efficiency of multidetector computed tomography (MDCT) in the detection of blunt bowel and mesenteric injuries (BBMI), and the role of different experience levels in using MDCT. METHODS: This study included a test group of twenty-seven patients with surgically important BBMI in whom the diagnoses were confirmed after surgical intervention (23 men and 4 women; mean age, 40.7±16.2; range, 18-76), and a control group of twenty-one matched patients without BBMI who underwent laparotomy for trauma during the same time period (16 men and 5 women; mean age, 38.9±14.5; range, 20-68) and sixteen-detector computed tomography prior to surgery. Intraoperative findings were compared with MDCT findings. RESULTS: High accuracy, specificity, and positive predictive values in MDCT findings with respect to intraperitoneal free air, mesenteric air, thickened (>4-5 mm) and defected bowel wall, increased contrast enhancement on bowel wall, and mesenteric hematoma were found among others (p<0.01). Sensitivities and specificities of the diagnosis of BBMI by the resident and staff radiologist was 74% and 71%, and 85% and 100%, respectively. CONCLUSION: MDCT displays BBMI with high sensitivity and specificity, and can predict the need for surgery. Experience in radiology is an important factor for appropriate interpretation of the MDCT findings.
CT of blunt trauma to the bowel and mesentery
American Journal of Roentgenology, 1993
Injuries to the bowel and mesentery are found in approximately 5% of all patients undergoing laparotomy after blunt abdominal trauma. Bowel and mesenteric injuries are often subtle and difficult to diagnose, and a delay in the diagnosis is associated with increased mortality and morbidity. CT is the best imaging method for diagnosing injuries to the bowel and mesentery. With meticulous scanning techniques, most significant bowel and mesenteric injuries can be reliably identified with CT preoperatively, and associated injuries to other abdominal viscera can be confirmed.
Journal of Medical Science And clinical Research, 2019
Multidetector computed tomography (CT) is the primary imaging modality for diagnosing bowel and mesenteric blunt trauma. Pneumoperitoneum is the commonly observed for imaging sign among radiologists. There are, however, other CT findings with different clinical significances. The aim of this article is to heighten radiologist awareness regarding the diagnostic capability of CT in bowel and mesenteric blunt trauma, and to illuminate potential pitfalls to be avoided in this patient population. This guide was developed to enhance the knowledge and awareness of non-expert radiologists that may be less aware of the nuances of abdominal CT imaging in a blunt trauma setting. This enhanced knowledge and awareness will improve patient diagnosis, treatment, and outcomes.
European Journal of Radiology, 2004
The CT diagnosis of bowel and mesenteric injuries is difficult and warrants optimal technique and skilled interpretation. We retrospectively reviewed 36 consecutive patients with blunt traumatic injuries to the bowel and mesentery at our regional level I trauma center during the past 3 years. Physical examination, laboratory, Computed tomographic (CT), and intraoperative findings were compared. Surgically proven bowel injuries (13 cases) occurred in the duodenum (three cases), ileum (two cases), jejunum (two cases), colon (three cases), and stomach (three cases). CT findings considered specific of bowel rupture were observed in 5/13 patients including: extraluminal oral contrast or luminal content extravasation (four cases) and discontinuity of hollow viscus wall (one case). In the remaining 8/13 CT findings considered suggestive of bowel injury consisted of: pneumoperitoneum (six), gas bubbles close to the injured hollow viscus (three), thickened (>4-5 mm) bowel wall (five), bowel wall hematoma (three), intraperitoneal fluid of unknown source (three). Mesenteric injury (23 cases) were surgically observed at the level of the mesenteric vessels (17 cases), legament of Treitz (two cases), gastro-duodenal artery (one case), transverse (one case) and sigmoid mesocolon (one case). CT finding considered specific of mesenteric laceration was active extravasation of contrast material from the mesenteric vessels (10 cases). CT findings suggestive of mesenteric injury (13 cases) consisted of: mesenteric hematoma (five) and/or high attenuation fluid collections, within the mesenteric root (eight) and folds (four).
Blunt bowel and mesenteric injury: MDCT diagnosis
Abdominal Imaging, 2011
Multidetector computed tomography (MDCT) has emerged as the imaging modality of choice for evaluating the abdomen and pelvis in trauma patients. MDCT readily detects injury of the solid organs as well as direct and indirect features of bowel and/or mesenteric injury—an important advance given that unrecognized bowel and mesenteric injuries may result in high morbidity and mortality. Nonetheless, challenges persist
The Prognosis of Blunt Bowel and Mesenteric Injury—The Pitfall in the Contemporary Image Survey
Journal of Clinical Medicine, 2019
Delayed diagnosis and intervention of blunt bowel and mesenteric injury (BBMI) is a hazard because of poor prognosis. Computed tomography (CT) is the standard imaging tool to evaluate blunt abdominal trauma (BAT). However, a high missed diagnosis rate for BMMI was reported. In this study, we would like to evaluate the presentation of CT in BBMI. Moreover, we want to evaluate the impact of deferred surgical intervention of BBMI on final prognosis. We performed a retrospective study from 2013–2017, including patients with BAT and BBMI who underwent surgical intervention. We evaluated clinical characteristics, CT images, and surgical timing, as well as analyzed the prognosis of BBMI. There were 6164 BAT patients and 188 BMI patients included. The most common characteristics of CT were free fluid (71.3%), free air (43.6%), and mesenteric infiltration (23.4%). There were no single characteristics of a CT image that can predict BBMI significantly. However, under close monitoring, we find ...