title: Jejunum and ileum blunt trauma: what has changed with the implementation of multislice computed tomography?
abstract: OBJECTIVE
  to evaluate the impact of the new technology of multidetector computed tomography (MDCT) in improving the accuracy and early diagnosis of BSBI.
  
  
  METHODS
  patients with blunt small bowel injuries (BSBI) grade> I were identified retrospectively and their CT scans reviewed by an experienced radiologist. Clinical and tomographic findings were analyzed and patients grouped as "pre-MDCT" and "post-MDCT", according to the time of implementation of a 64-slice MDCT.
  
  
  RESULTS
  of the 26 patients with BSBI 16 had CT scans. Motor vehicle collision (62.5%) was the most frequent mechanism of injury. In the pre-MDCT period, five of the 13 patients (38.5%) had abdominal CT, and in the post-MDCT, 11 of 13 patients (84.6%) had the exam. During pre-MDCT, all CT scans were abnormal with findings of pneumoperitoneum (60%), free fluid (40%) and bowel wall enhancement (20%). In the post-MDCT group, all exams but one were abnormal and the most frequent findings were free fluid (90.9%), bowel wall enhancement (72.7%), and pneumoperitoneum (54.5%). However, the rate of delayed laparotomy did not change. The mortality rate in both groups were similar, with 20% during pre-MDCT and 18.2% during post-MDCT.
  
  
  CONCLUSIONS
  the use of MDCT in abdominal trauma in our service has increased the sensibility of the diagnosis, but has had no impact on outcome so far.
authors.affiliation: School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Raquel Oliveira Menna Barreto
authors.initials: RO
authors.lastname: de Araújo
authors.affiliation: School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Marina Pimentel
authors.initials: MP
authors.lastname: de Matos
authors.affiliation: Department of Radiology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Thiago José
authors.initials: TJ
authors.lastname: Penachim
authors.affiliation: Departmentof Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Bruno Monteiro Tavares
authors.initials: BM
authors.lastname: Pereira
authors.affiliation: Departmentof Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Mario Eduardo de Faria
authors.initials: ME
authors.lastname: Mantovani
authors.affiliation: Department of Surgery and Critical Care Medicine, University of Toronto, Toronto, Canada.
authors.forename: Sandro
authors.initials: S
authors.lastname: Rizoli
authors.affiliation: Departmentof Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Gustavo Pereira
authors.initials: GP
authors.lastname: Fraga
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000293:injuries*; D007583:Jejunum / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D055815:Young Adult