Keywords:
Gastrointestinal tract
Authors:
A. Mahajan1, V. R. K. Rao2, M. Thakur1; 1Mumbai/IN, 2Manipal/IN
DOI:
10.1594/ecr2010/C-3321
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/No
Wall 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 Yes/No
Mesenteric hematoma +/-
Mesenteric streaking +/-
Mesenteric gas +/-
Bowel injury scale (1994 revision Moore et al)
Grade | Injury type | Description of injury |
I | Hematoma Laceration | Contusion or hematoma without devascularization Partial thickness, no perforation |
II | Laceration | Laceration <50% of circumference |
III | Laceration | Laceration > 50% of circumference without transection |
IV | Laceration | Transection of the bowel |
V | Laceration Vascular | Transection of the bowel with segmental tissue loss Devascularized segment |
CT MANAGEMENT AND CORRELATION ASSESSMENT:
The accuracy of the CT was evaluated on the basis of the final radiology report which were compared with either
1) Findings at laparotomy
2) Findings at follow up imaging if managed conservatively.
MANAGEMENT:
Conservative: yes/no
Follow up: recovered / deteriorated / died
OPERATIVE:
Emergency laparotomy yes/no
Emergency laparoscopy yes/no
Delayed laparotomy / laparoscopy yes/no
If operated: AAST & CT finding correlation
Follow up: recovered / deteriorated / died