Effectiveness of computed tomography scanning to detect blunt bowel and mesenteric injuries requiring surgical intervention: A systematic literature review

Abdel-Aziz, Hiba; Dunham, C. Michael

doi:10.1016/j.amjsurg.2018.08.018

Cited by 18 publications

(16 citation statements)

References 48 publications

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“…Much of the research regarding sensitivity and specificity of bowel injury though is based on data obtained through lesser quality CT scanners which may have improved in quality in recent years. A recent literature review combining all the data sets published between 1990 and 2015 evaluated the largest population group presented so far (11,924 patients) [ 29 ]. Of this group, the most sensitive sign was free peritoneal fluid.…”

Section: Blunt Abdominal Trauma: Role and Pitfalls Of Ct In The Diagn...mentioning

confidence: 99%

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

et al. 2022

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The aim of this paper was to review the recent literature to create recommendations for the day-to-day diagnosis and surgical management of small bowel and colon injuries. Where knowledge gaps were identified, expert consensus was pursued during the 8th International Congress of the World Society of Emergency Surgery Annual (September 2021, Edinburgh). This process also aimed to guide future research.

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Section: Blunt Abdominal Trauma: Role and Pitfalls Of Ct In The Diagn...mentioning

confidence: 99%

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

et al. 2022

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“…Due to high diagnostic value, CT is undeniably the imaging tool of choice in haemodynamically stable polytrauma patients [ 28 ], with a sensitivity of 80–95 % and specificity of 48–96 % for detecting sBBMI [ 16 , 23 , 27 , 29 ]. However, despite technical advancements, false negative results occur [ 3 , 6 , 8 , 10 , 27 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Localised mesenteric fat stranding or mesenteric haematoma should prompt careful examination of the adjacent bowel loops, as extra-intestinal signs may be more striking than the underlying bowel injury. Finally, one should consider repeating the abdominal CT in selected patients, when initial images are unimpressive, but clinical signs remain worrisome [ 20 , 29 ], as in four of our patients with sBBMI.…”

Section: Discussionmentioning

confidence: 99%

Significant blunt bowel and mesenteric injury – Comparison of two CT scoring systems in a trauma registry cohort

Keller

Zingg

Agri

et al. 2021

European Journal of Radiology Open

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“…There were no significant differences in age, sex, ED vital signs, Revised Trauma Scale score, or TRISS between the two groups. Motorcyclists had a significantly higher ISS (median [Q1-Q3], 18 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] vs. 16 [9][10][11][12][13][14][15][16][17][18], p = 0.044) and lower GCS score (15 [11-15] vs. 15 , p = 0.034) than car occupants. In terms of management, significant differences in the rate of intubation at the ED and unplanned intubation during hospitalization were not found between the two groups.…”

Section: Clinical Characteristics and Outcomes Of Motorcyclists And C...mentioning

confidence: 99%

“…However, studies of BBMIs regarding the different injury mechanisms are scant in the literature. Furthermore, while the extant literature on BBMI has assessed the accuracy or effectiveness of imaging [ 2 , 15 , 16 ], risk factors of morbidity and mortality [ 17 ], and diagnostic delay [ 2 , 18 , 19 ], the implications of BBMI and road traffic accidents have not been explored extensively. This study aimed to investigate the differences in injury characteristics and outcomes of trauma patients with surgical BBMI between those motorcyclists and car occupants.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Cohort Study on the Clinical Characteristics of Patients with Surgical Blunt Bowel and/or Mesenteric Injuries among Motorcyclists and Car Occupants

et al. 2022

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(1) Background: Surgical blunt bowel and/or mesenteric injuries (BBMIs) are rare but challenging for trauma surgeons. Surgical BBMI is associated with specific injury mechanisms, such as direct compression by the handlebar in motorcycle accidents or rapid acceleration and deceleration of the impact forces associated with seatbelt injuries in motor vehicle collisions. However, the discussions on the implications of BBMI and the mechanisms of road traffic accidents remain scarce. This retrospective study assessed the clinical and injury characteristics of surgically proven BBMI among motorcyclists and car occupants based on trauma-registered data obtained from a level I trauma center in Taiwan. (2) Methods: Medical data of 72 motorcyclists and 38 car occupants who had surgical BBMI between January 2009 and December 2020 were reviewed. Patient characteristics, injuries, and outcomes in both groups were compared and analyzed. (3) Results: Motorcyclists with surgical BBMI had a significantly higher Injury Severity Score (median [Q1–Q3], 18 (9–27) vs. 16 (9–18), p = 0.044) and lower Glasgow Coma Scale score (15 (11–15) vs. 15 (15–15), p = 0.034]) than car occupants. Motorcyclists with surgical BBMI had a higher incidence of pelvic fractures (18.1% vs. 2.6%, p = 0.032) and upper limb fractures (23.6% vs. 7.9%, p = 0.042) and a significantly higher rate of chest tube insertion than car occupants (29.2% vs. 10.5%, p = 0.027). However, there were no significant differences in the outcomes of morbidity and mortality between motorcyclists and car occupants with surgical BBMI. (4) Conclusions: This study demonstrated there were no significant differences in outcomes between motorcyclists and car occupants with surgical BBMI. However, motorcyclists with surgical BBMI were injured more severely, along with injuries to the head/neck and extremities, than car occupants.

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Effectiveness of computed tomography scanning to detect blunt bowel and mesenteric injuries requiring surgical intervention: A systematic literature review

Cited by 18 publications

References 48 publications

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

Significant blunt bowel and mesenteric injury – Comparison of two CT scoring systems in a trauma registry cohort

A Retrospective Cohort Study on the Clinical Characteristics of Patients with Surgical Blunt Bowel and/or Mesenteric Injuries among Motorcyclists and Car Occupants

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