Blunt Injury of the Bowel and Mesentery

Dattwyler, Matthew; Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan

doi:10.1007/s40134-018-0276-6

Cited by 5 publications

(12 citation statements)

References 41 publications

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“…These criteria reflect the incorporation of CT scanning into the evaluation of trauma patients both with blunt and penetrating mechanisms. [2][3][4][5][6] The OIS was reviewed and approved by the board of managers of the AAST.…”

Section: Methodsmentioning

confidence: 99%

Organ Injury Scaling 2020 update: Bowel and mesentery

Tominaga

Crandall

Cribari³

et al. 2021

J Trauma Acute Care Surg

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Section: Methodsmentioning

confidence: 99%

Organ Injury Scaling 2020 update: Bowel and mesentery

Tominaga

Crandall

Cribari³

et al. 2021

J Trauma Acute Care Surg

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“…Motor vehicle collision, physical assault, sports-related trauma, and fall from a height remain the most frequent causes of blunt bowel and mesenteric injuries [ 8 ]. First, three patterns of blunt force include compression, acceleration–deceleration, and overpressure [ 9 ].…”

Section: Epidemiology Pathomechanism and Clinical Evaluationmentioning

confidence: 99%

“…The scan should be performed at least 6 h after the initial CT to allow abnormalities to evolve and manifest [ 1 ]. Some studies have suggested that the repeat scan be performed 24–48 h following trauma, although any decision should be weighed against the risks of delaying surgery to treat significant injuries [ 8 21 ]. Concerning a suspected proximal bowel injury, such as in the duodenum, an immediate repeat CT with oral contrast can be helpful in differentiating full-thickness injury from partial-thickness injury when the initial CT is inconclusive and no clinical signs warrant immediate laparotomy [ 22 ].…”

Section: Imaging Evaluationmentioning

confidence: 99%

“…In general, the larger the amount of free fluid, the higher the likelihood of it being pathological [ 23 ]. Fluid between bowel loops or within the mesenteric folds (appearing as triangular-shaped fluid or at least one border being a straight line on CT) is more specific for bowel and mesenteric injuries than fluid in other peritoneal spaces [ 8 16 ].…”

Section: Detecting the Abnormalities On Ctmentioning

confidence: 99%

“…Hematoma within the bowel wall appears as intrinsic high attenuation on unenhanced CT or virtual non-contrast CT images that can be focal or segmental. On contrast-enhanced images, this is generally masked by wall enhancement and appears as wall thickening [ 8 ]. When large, the hematoma may exert a mass effect on or against the bowel lumen, resulting in bowel obstruction.…”

Section: Detecting the Abnormalities On Ctmentioning

confidence: 99%

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Radiologic Imaging of Traumatic Bowel and Mesenteric Injuries: A Comprehensive Up-to-Date Review

et al. 2023

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Diagnosing bowel and mesenteric trauma poses a significant challenge to radiologists. Although these injuries are relatively rare, immediate laparotomy may be indicated when they occur. Delayed diagnosis and treatment are associated with increased morbidity and mortality; therefore, timely and accurate management is essential. Additionally, employing strategies to differentiate between major injuries requiring surgical intervention and minor injuries considered manageable via non-operative management is important. Bowel and mesenteric injuries are among the most frequently overlooked injuries on trauma abdominal computed tomography (CT), with up to 40% of confirmed surgical bowel and mesenteric injuries not reported prior to operative treatment. This high percentage of falsely negative preoperative diagnoses may be due to several factors, including the relative rarity of these injuries, subtle and non-specific appearances on CT, and limited awareness of the injuries among radiologists. To improve the awareness and diagnosis of bowel and mesenteric injuries, this article provides an overview of the injuries most often encountered, imaging evaluation, CT appearances, and diagnostic pearls and pitfalls. Enhanced diagnostic imaging awareness will improve the preoperative diagnostic yield, which will save time, money, and lives.

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