Imaging of Blunt Bowel and Mesenteric Injuries: Current Status

Publication date: Available online 13 February 2020Source: European Journal of RadiologyAuthor(s): Mostafa Alabousi, Vincent M. Mellnick, Rayeh Kashef Al-Ghetaa, Michael N. PatlasAbstractBlunt abdominal trauma often presents a diagnostic challenge. Clinical examination demonstrates low reliability in detecting abdominal injury (16%) when there is a history of head injury or loss of consciousness. This can prove detrimental, as delays in the diagnosis of traumatic bowel injury of 8 hours or less can result in increased morbidity and mortality, as well as prolonged hospitalization. Although hemodynamically unstable patient will require an urgent laparotomy following clinical assessment, MDCT is the modality of choice for comprehensive imaging of blunt abdominal trauma in hemodynamically stable patients. Despite the use of MDCT, blunt injury to the bowel and mesentery, which accounts for up to 5% of injuries in cases of trauma, may be difficult to detect. The use of a constellation of direct and indirect signs on MDCT can help make the diagnosis and guide clinical management. Direct signs on MDCT, such as bowel wall discontinuity, and extraluminal gas may assist in the diagnosis of traumatic bowel injury. However, these signs are not sensitive. Therefore, the astute radiologist may have to rely on indirect signs of injury, such as free fluid, bowel wall thickening, and abnormal bowel wall enhancement to make the diagnosis. This review will focus on MDCT imaging findings of bow...
Source: European Journal of Radiology - Category: Radiology Source Type: research