title: Multidetector CT findings of bowel transection in blunt abdominal trauma.
abstract: OBJECTIVE
  Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma.
  
  
  METHODS
  We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage.
  
  
  RESULTS
  The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection.
  
  
  CONCLUSIONS
  Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.
authors.affiliation: Department of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 150-950, Korea.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Cho
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Woo
authors.forename: Hye-Suk
authors.initials: HS
authors.lastname: Hong
authors.forename: Mee Hyun
authors.initials: MH
authors.lastname: Park
authors.forename: Hong Il
authors.initials: HI
authors.lastname: Ha
authors.forename: Ik
authors.initials: I
authors.lastname: Yang
authors.forename: Yul
authors.initials: Y
authors.lastname: Lee
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Jung
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Hwang
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
keywords: Blunt abdominal trauma; Bowel transection; MDCT
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