Blunt bowel and mesenteric injury: MDCT diagnosis.
Multidetector computed tomography (MDCT) has emerged as the imaging modality of choice for evaluating the abdomen and pelvis in trauma patients. MDCT readily detects injury of the solid organs as well as direct and indirect features of bowel and/or mesenteric injury-an important advance given that unrecognized bowel and mesenteric injuries may result in high morbidity and mortality. Nonetheless, challenges persist in the interpretation of abdominal and pelvic CT images in trauma patients. Difficulty in interpretation may result from lack of familiarity with or misunderstanding of CT features of bowel and/or mesenteric injury. Moreover, due to major technical advances afforded by MDCT, new CT features of bowel and/or mesenteric injuries have been recognized. Beading and termination of mesenteric vessels indicating surgically important mesenteric injury is an example of one of these new features. MDCT also allows for the detection of small or trace amounts of isolated intraperitoneal fluid in trauma patients, although the clinical management of these patients is still controversial. This pictorial essay illustrates the spectrum of typical, atypical, and newly reported MDCT features of bowel and mesenteric injuries due to blunt trauma. The features that help to differentiate these injuries from pitfalls are emphasized in these proven cases.
Yu
Jinxing
J
Department of Radiology, Virginia Commonwealth University Health System, Richmond, 23298-0615, USA. jyu1@vcu.edu
Fulcher
Ann S
AS
Turner
Mary A
MA
Cockrell
Charles
C
Halvorsen
Robert A
RA
D000007:Abdominal Injuries / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging* / Q000293:injuries*; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D055815:Young Adult
D003287:Contrast Media