Helena F. Termes, Presenter: Nothing to Disclose

Mireia Teixidor Vinas, Abstract Co-Author: Nothing to Disclose

Marina Febrer MD, Abstract Co-Author: Nothing to Disclose

Jorge Soriano, Abstract Co-Author: Nothing to Disclose

Margarita Osorio MD, Abstract Co-Author: Nothing to Disclose

Ramon Farres, Abstract Co-Author: Nothing to Disclose

1. To review the specific multidetector computed tomography (MDCT) findings in blunt abdominal trauma with bowel and mesenteric injuries. 2. To analyze the lesions associated with bowel and mesenteric injuries. 3. To illustrate the ability of MDCT with multiplanar reformation (MPR), maximum intensity projection (MIP), and volume rendering (VR) reconstructions to demonstrate the criteria for emergency surgical treatment of bowel and mesenteric injuries.

We reviewed 1284 whole-body MDCT studies of multiple trauma patients performed in our institution, over a 4-year period (2007-2010). The analysis included MPR, MIP, and VR reconstructions as well as three-dimensional postprocessing.

1284 consecutive trauma patients (974 m and 310 f; median age, 37 y; age range, 17 m – 92 y) underwent standardized whole-body MDCT. Trauma resulted from automobile accidents (62.8%), motorcycle accidents (18.6%), falls (11.4%), and other causes (6.85%). Bowel or mesenteric injury was diagnosed in 70 (5.45%) patients (53 m and 17 f).  The most frequent associated lesions were osseous fractures (41.4%), abdominal visceral lesions (31.4%), thoracic injuries (25.7%), and brain lesions (15.7%). Vascular and diaphragmatic injuries were rare. 48 patients were conservatively managed and 20 patients underwent surgery for bowel or mesenteric injury (8 for pneumoperitoneum, 5 for active bleeding, 3 for mesenteric contusion, 2 for hemodynamic instability, 1 for increased free fluid at early follow-up, and 1 for increased pain). 2 patients died before therapeutic decision.    

MDCT is the diagnostic test of choice in the assessment of bowel and mesenteric injuries in hemodynamically stable patients with blunt abdominal trauma. Early diagnosis of bowel and mesenteric injuries is imperative to detect criteria for surgical treatment that can reduce mortality and morbidity in these patients.

MDCT in trauma patients with bowel or mesenteric injuries can demonstrate specific findings indicating the need for surgery.

F. Termes, H, Teixidor Vinas, M, Febrer, M, Soriano, J, Osorio, M, Farres, R, Bowel and Mesenteric Injuries in Emergent Trauma: The Hidden Danger.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002801.html