CT of Blunt Trauma Bowel and Mesenteric Injury

CT of Blunt Trauma Bowel and Mesenteric Injury

http://radiographics.rsna.org/content/20/6/1525.full

Jeffrey M. Brody, MD ; Danielle B. Leighton, MD ; Brian L. Murphy, MD ; Gerald F. Abbott, MD ; Jonathan P. Vaccaro, MD ; Liudvikas Jagminas, MD ; William G. Cioffi, MD

1 From the Departments of Diagnostic Imaging (J.M.B., D.B.L., B.L.M., G.F.A., J.P.V.), Emergency Medicine (L.J.), and Surgery (W.G.C.), Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903. Recipient of a Certificate of Merit award for a scientific exhibit at the 1999 RSNA scientific assembly. Received March 27, 2000; revision requested April 25 and received June 28; accepted July 6.

Detection of bowel and mesenteric injury can be challenging in patients after blunt abdominal trauma. Early diagnosis and treatment are critical to decrease patient morbidity and mortality. Computed tomography (CT) has become the primary modality for the imaging of these patients. Signs of bowel perforation such as free air and contrast material are virtually pathognomonic. Bowel-wall thickening, free fluid, and mesenteric infiltration may be seen with this type of injury and partial thickness injuries. The authors present and discuss the range of CT findings seen with bowel and mesenteric injuries. Examples of observation and interpretation errors are also provided to highlight pitfalls encountered in the evaluation of abdominopelvic CT scans in patients after blunt trauma.