Diagnosis of Blunt Intestinal and Mesenteric Injury in the Era of Multidetector CT Technology—Are Results Better?

Ekeh, Akpofure Peter; Saxe, Jonathan M.; Walusimbi, Mbaga S.; Tchorz, Kathryn M.; Woods, Randy J.; Anderson, Harry L.; McCarthy, Mary C.

doi:10.1097/ta.0b013e3181801cf0

Cited by 59 publications

(51 citation statements)

References 38 publications

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“…Ekeh et al [24] found that missed injuries remain common in BBMI even in the current era of multislice CT scanner. According to them free fluid without solid organ injury, though not specific, continues to be an important finding and adjuncts to CT continue to be necessary for the optimal diagnosis of bowel injury.…”

Section: Discussionmentioning

confidence: 99%

Multi Detector Computed Tomography in the Diagnosis of Bowel Injury

2012

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Bowel Injuries are uncommonly associated with traumatic abdominal injuries. However, they are associated with significant morbidity and mortality and require operative intervention unlike solid organ injuries. Hence, early diagnosis is of paramount importance. Computed tomographic (CT) scan is a well-established and highly accurate imaging modality for the detection of solid organ injury after blunt abdominal trauma. However, its role in diagnosing hollow viscus injury remains controversial. The aim of our study was to analyze the accuracy of multidetector CT (MDCT) in the diagnosis of bowel injury. Imaging features of surgically proven cases of bowel injury were identified over 8-year period (i.e., from January 2003 to December 2010) and were retrospectively analyzed. There were 32 patients with age range of 3-90 years. There was only one female. Sensitivity of various CT signs specific to bowel injury (i.e., extravasation of contrast and discontinuity of bowel wall) was 15.62, and 28.12%, respectively. While that of signs suggestive of bowel injury were pneumoperitoneum, 62.5%; gas in the vicinity, 40.62%; bowel wall hematoma, 21.87%; bowel wall thickening, 75%; ascites, 78.12%; mesenteric hematoma, 46.87%; and mesenteric stranding, 40.62%. Based on the major and minor signs, a diagnosis of bowel injury could be made in all patients except one. The minor signs showed a higher sensitivity than the major signs. Hence, we recommend that multidetector CT should be used as the modality of choice in case of patients with suspected bowel injury. We also suggest that the minor signs should be given as much importance as the major signs.

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Section: Discussionmentioning

confidence: 99%

Multi Detector Computed Tomography in the Diagnosis of Bowel Injury

2012

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“…It is highly reliable for intra-abdominal solid organ injury diagnosis and is now considered accurate in the diagnosis of bowel and mesenteric injuries complicating blunt abdominal trauma [5]. Many CT findings of BBMI have been reported, some of which are specific, but most are only suggestive, and the exact diagnostic performance of CT remains debatable, with experienced readers yielding more accurate diagnoses [2,[6][7][8][9][10][11][12]. Moreover, some BBMI, e.g.…”

Section: Introductionmentioning

confidence: 99%

Value of CT to predict surgically important bowel and/or mesenteric injury in blunt trauma: performance of a preliminary scoring system

et al. 2015

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“…9 Ekeh et al demonstrated that despite the use of CT technology 11 patients out of 82 (13%) patients had delayed recognition of bowel /mesenteric injury. 10 Associated extra abdominal injuries were noted in 18 patients (62%). The most common associated injury was skeletal injuries.…”

Section: Discussionmentioning

confidence: 99%

Recognition and management of small bowel and mesenteric injuries in blunt abdominal trauma

2016

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Diagnosis of Blunt Intestinal and Mesenteric Injury in the Era of Multidetector CT Technology—Are Results Better?

Abstract: Missed injuries remain common in BBMI even in the current era of multislice CT scanners. Free fluid w/o solid organ injury, though not specific, continues to be an important finding. Adjuncts to CT continue to be necessary for the optimal diagnosis of bowel injuries.

Cited by 59 publications

References 38 publications

Multi Detector Computed Tomography in the Diagnosis of Bowel Injury

Multi Detector Computed Tomography in the Diagnosis of Bowel Injury

Value of CT to predict surgically important bowel and/or mesenteric injury in blunt trauma: performance of a preliminary scoring system

Recognition and management of small bowel and mesenteric injuries in blunt abdominal trauma

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