Blunt injury of the small intestine and mesentery???the trauma surgeon??s Achille??s heel?

Bloom, Allan I.; Rivkind, Avraham I.; Zamir, Gideon; Gross, Erica R.; Kluger, Yoram; Reissman, P; Muggia-Sullam, Michael

doi:10.1097/00063110-199606000-00005

Cited by 26 publications

(30 citation statements)

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“…The diagnosis of bowel and mesenteric injury has been notoriously difficult to establish rapidly in blunt trauma patients (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Trauma surgeons are aware of this correlation and routinely ''run the bowel'' to look specifically for bowel and mesenteric injury (1)(2)(3)(4). Bowel and mesenteric injury remains very difficult to precisely localize by using any means (5). Physical examination results may be suggestive but are not reliable in differentiating bowel and mesenteric injury from other intraabdominal injuries (6,10,11).…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of intraabdominal injuries from blunt trauma continues to increase worldwide (1)(2)(3)(4)(5). At our institution, bowel and mesenteric injuries represent a substantial portion of the total number of intraabdominal injuries; they have approximated 20% over the past 5 years.…”

mentioning

confidence: 99%

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Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US

Richards¹,

McGahan²,

Simpson³

et al. 1999

Radiology

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“…The diagnosis of bowel and mesenteric injury has been notoriously difficult to establish rapidly in blunt trauma patients (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US

Richards¹,

McGahan²,

Simpson³

et al. 1999

Radiology

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“…MacGahan JP et al demonstrated a sensitivity of 44% for diagnosis of isolated gastrointestinal injury by FAST [21]. They also showed that free abdominal fluid was not detected in the majority of patients with isolated bowel and mesenteric injury.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": the role of repeated ultrasonography

Mohammadi

Ghasemi-Rad

2012

World J Emerg Surg

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BackgroundTo determine the diagnostic Accuracy of Focused Assessment Sonography for Trauma (FAST) and repeated FAST in the patients with blunt abdominal trauma.MethodsIn this retrospective study we collected the data of all patients from September 2007 to July 2011 with gastrointestinal injury. The intraoperative outcome was compared with FAST technique and the repeated or delayed sonography.ResultsA total number of 1550 patients with blunt abdominal trauma underwent FAST in a period of 4 years in our hospital. Eighty-eight (5.67%) patients were found to have gastrointestinal injury after exploratory laparotomy. Fifty-five (62.5%) patients had isolated gastrointestinal injury and 33 (37.5%) patients had concomitant injury to the other solid organs. In those with isolated gastrointestinal injury, the sensitivity of FAST was 38.5%. Repeated ultrsonography was performed in 34 patients with false negative initial FAST after 12-24 hours. The sensitivity of repeated ultrasonography in negative initial FAST patients in detection of gastrointestinal injury was 85.2% (95% CI, 68.1%, and 94.4%).ConclusionRepeated sonography after 12 to 24 hours in patients with negative initial FAST but sustain abdominal symptom can facilitated a diagnosis of GI tract injury and can be as effective method instead of Computed tomography in developing country.

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“…Blunt trauma poses a diagnostic and therapeutic challenge to the trauma surgeon [1]. Modern imaging modalities such as ultrasound (US) and computed tomography (CT) are able to determine the presence and degree of injury to solid organs in more than 95% of cases.…”

Section: Introductionmentioning

confidence: 99%

Delayed Presentations of Blunt Mesenteric and Intestinal Trauma in the Wake of Injury

Edden

Miklosh

Pappo

et al. 2007

Eur J Trauma Emerg Surg

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Acceleration-deceleration abdominal injury affects the terminal ileum more commonly. We propose that the ensuing clinical picture depends on the level of energy transmitted: high-energy trauma leads to extensive mesenteric and bowel tears and is diagnosed immediately. Low-energy trauma may lead to chronic ischemia, fibrosis and stricture-formation. The right colon appears to be more vulnerable to lowflow states following blunt trauma.

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Blunt injury of the small intestine and mesentery???the trauma surgeon??s Achille??s heel?

Cited by 26 publications

References 0 publications

Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US

Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US

Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": the role of repeated ultrasonography

Delayed Presentations of Blunt Mesenteric and Intestinal Trauma in the Wake of Injury

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