Purpose
INTRADUCTION:•Detection of bowel and mesenteric injury can be challenging in patients after blunt abdominal trauma. Early diagnosis and treatment are critical to decrease patient morbidity and mortality.•A survey of the members of the AAST showed 77% now use CT scanning most or all of the time for diagnosis of blunt injury of the bowel and mesentery.•Because so much emphasis is now placed on CT, this study highlights the typical CT findings associated with bowel and mesenteric injury due to blunt trauma.•In addition, we present some...
Methods and Materials
Hospital-based study conducted from MAY 2004 to JAN 2008.Selection Criteria of the patient:•Patients with blunt abdominal trauma who underwent CT for evaluation of intra-abdominal injury prior to surgery. Exclusion Criteria of the patient:•Patients who did not have a follow up (laparotomy / follow up imaging if managed conservatively) were excluded.CT FINDINGS: BOWEL INJURY Yes/NoWall thickening +/-Intramural gas +/-Wall discontinuity +/-Free air +/-Free fluid, no visceral injury +/-% bowel wall laceration:Bowel wall ischemia: +/-Wall enhancement +/-Extraluminal feces +/-Paralytic ileus +/-Shock bowel +/- AAST OIS: MESENTERIC INJURY...
Results
•BBMI occurred in 45 patients (28%). CT showed 37 cases having associated mesenteric injuries.•The mean age was 33 yrs, and 82 % were male.•78 % of patients had CT done within 12 hrs of the trauma.•The major cause of BBMI in our study was RTA (76%).BBMI AND CT FINDIGNS CORRELATION:•Extraluminal air and oral contrast material and intramural air were virtually pathognomonic of bowel injury. However they were occasionally seen.•Thickened bowel wall though subjective was useful sign that indicated not only bowel but also mesenteric injury.•Mesenteric...
Conclusion
•CT is sensitive for the diagnosis of bowel rupture resulting from blunt trauma, but careful inspection and technique are required to detect often subtle findings.•CT findings in intestinal perforation can be subtle and nonspecific.•Any unexplained abnormality on CT after blunt abdominal trauma may signal the presence of intestinal perforation and warrants close clinical observation or further diagnostic tests.•Bowel wall thickening, bowel wall discontinuity, extraluminal air, and mesenteric hematoma are reasonably specific CT signs of bowel and mesenteric injury following blunt abdominal trauma.•The presence of a...
References
Sherck J, Shatney C, Sensaki K, Selivanov V (1994) The Accuracy of computed tomography in the diagnosis of blunt small bowel perforation. Am J Surg 168: 670-675.Hagiwara A, Yukioka T, Satou M, Yoshii H, Yamamoto S, Matsuda H, Shimazaki S (1995) Early diagnosis of small intestine rupture from blunt abdominal trauma using computed tomography: significance of the streaky density within the mesentery. J Trauma 38 (4): 630-633.Hamilton P, Rizoli S, McLellan B, Murphy J (1995) Significance of intra-abdominal extraluminal air detected by CT scan in...
Personal Information
Author details:Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]