title: Bowel and mesenteric injury in blunt trauma: diagnostic efficiency and importance of experience in using multidetector computed tomography.
abstract: BACKGROUND
  The purpose of this study was to investigate the diagnostic efficiency of multidetector computed tomography (MDCT) in the detection of blunt bowel and mesenteric injuries (BBMI), and the role of different experience levels in using MDCT.
  
  
  METHODS
  This study included a test group of twenty-seven patients with surgically important BBMI in whom the diagnoses were confirmed after surgical intervention (23 men and 4 women; mean age, 40.7±16.2; range, 18-76), and a control group of twenty-one matched patients without BBMI who underwent laparotomy for trauma during the same time period (16 men and 5 women; mean age, 38.9±14.5; range, 20-68) and sixteen-detector computed tomography prior to surgery. Intraoperative findings were compared with MDCT findings.
  
  
  RESULTS
  High accuracy, specificity, and positive predictive values in MDCT findings with respect to intraperitoneal free air, mesenteric air, thickened (>4-5 mm) and defected bowel wall, increased contrast enhancement on bowel wall, and mesenteric hematoma were found among others (p<0.01). Sensitivities and specificities of the diagnosis of BBMI by the resident and staff radiologist was 74% and 71%, and 85% and 100%, respectively.
  
  
  CONCLUSIONS
  MDCT displays BBMI with high sensitivity and specificity, and can predict the need for surgery. Experience in radiology is an important factor for appropriate interpretation of the MDCT findings.
authors.affiliation: Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey. veyselp@hotmail.com.
authors.forename: Ahmet Veysel
authors.initials: AV
authors.lastname: Polat
authors.affiliation: Department of Radiology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Aydın
authors.affiliation: Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Mehmet Selim
authors.initials: MS
authors.lastname: Nural
authors.affiliation: Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Selim Baris
authors.initials: SB
authors.lastname: Gul
authors.affiliation: Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Ayfer
authors.initials: A
authors.lastname: Kamali Polat
authors.affiliation: Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Kerim
authors.initials: K
authors.lastname: Aslan
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007422:Intestines / Q000293:injuries* / Q000601:surgery; D007813:Laparotomy; D008297:Male; D008643:Mesentery / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult