The role of computed tomography in diagnosis of blunt intestinal and mesenteric trauma (BIMT).
Blunt intestinal mesenteric trauma (BIMT) is a rare injury with a high morbidity and mortality. It is a diagnostic dilemma for Trauma Surgeons and Emergency Physicians. This study was undertaken to assess the role of computed tomography (CT) in BIMT. Data were analyzed from 1995 to 2002. Thirty-six cases of BIMT were identified: 16 isolated and 20 non-isolated injuries. Initial CT scan was abnormal in 74% (17 out of 23), and 83% on retrospect (2 additional cases). CT scans were abnormal (initial and repeat) in 96% (22 out of 23). The most common abnormalities were free fluid (78%), mesenteric stranding or edema (39%), bowel wall hematoma, or edema (30%). Free air was seen in 31% and oral contrast extravasation in 15% of cases of bowel perforation. CT scan findings in BIMT can be subtle and non-specific. Suspicion of BIMT warrants close observation and probably further diagnostic testing.
Sharma
Om P
OP
The Department of Trauma Services, The Toledo Hospital & Toledo Children's Hospital, 2142 North Cove Boulevard, Toledo, OH 43606, USA.
Oswanski
Michael F
MF
Singer
Daniel
D
Kenney
Brian
B
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004635:Emergency Medicine / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000293:injuries*; D010388:Pelvis / Q000000981:diagnostic imaging; D017064:Process Assessment, Health Care; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*