Skip to main content
SpringerLink
Log in

Imaging of Blunt Bowel and Mesenteric Injuries

  • Living reference work entry
  • First Online:
Atlas of Emergency Imaging from Head-to-Toe

  • 37 Accesses

Abstract

Bowel and mesenteric injuries due to blunt trauma are relatively uncommon; however, a prompt detection of such lesions is vital in order to decrease the mortality and morbidity due to a delayed diagnosis. In addition, since treatment algorithms are conservative oriented, this increases the need to identify bowel and mesenteric trauma early in the treatment process. Multidetector CT (MDCT) is considered the imaging modality of choice for the diagnosis of bowel and mesenteric traumatic injuries, although the detection of these injuries can be challenging because of the presence of multiple simultaneous injuries and subtle imaging findings. Several CT signs of bowel and mesenteric injuries due to blunt trauma have been described in the literature. The major objective in evaluating these signs is to differentiate significant bowel and mesenteric injuries that require surgical treatment from those that can be conservatively treated. Familiarity with direct and indirect CT findings of blunt bowel and mesenteric injuries as well as the recognition of those CT features requiring surgery is crucial to making a timely and accurate diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  1. Watts DR, Fakhry SM. Incidence of hollow viscus injury in blunt trauma: an analysis from 275.557 trauma admissions from the EAST Multi-Institutional trial. J Trauma. 2003;54:289–94.

    Article  Google Scholar 

  2. Williams MD, Watts DR, Fakhry SM. Colon injury after blunt abdominal trauma: results of the EAST multi-institutional hollow viscus injury study. J Trauma. 2003;55(5):906–12.

    Article  Google Scholar 

  3. Fakhry SM, Brownstein M, Watts DD, Baker CC, Oller D. Relatively short diagnostic delays (< 8 hours) produce morbidity and mortality in blunt small bowel injury: an analysis of time to operative intervention in 198 patients from a multicenter experience. J Trauma. 2000;48(3):408–14.

    Article  CAS  Google Scholar 

  4. Malinoski DJ, Patel MS, Yakar DO, Green D, et al. A diagnostic delay of 5 hours increases the risk of death after blunt hollow viscus injury. J Trauma. 2010;69:84–7.

    PubMed  Google Scholar 

  5. Scaglione M, de Lutio di Castelguidone E, Scialpi M, et al. Blunt trauma to the gastrointestinal tract and mesentery: is there a role for helical CT in the decision- making process? Eur J Radiol. 2004;50:67–73.

    Article  Google Scholar 

  6. Hughes TMD, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to a blunt trauma. Injury. 2002;33(4):295–302.

    Article  CAS  Google Scholar 

  7. Atri M, Hanson JM, Grinblat L, Brofman N, et al. Surgically important bowel and/or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation. Radiology. 2008;249(2):524–33.

    Article  Google Scholar 

  8. Brofman N, Atri M, Hanson JM, et al. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. RadioGraphics. 2006;26:1119–31.

    Article  Google Scholar 

  9. Khan I, Bew D, Elias DA, et al. Mechanisms of injury and CT findings of bowel and mesenteric trauma. Clin Radiol. 2014;69:639–47.

    Article  CAS  Google Scholar 

  10. Hughes TM, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma. Injury. 2002;33:295–302.

    Article  CAS  Google Scholar 

  11. Bates DDB, Wasserman M, Malek A, Gorantla V, et al. Multidetector CT of surgically proven blunt bowel and mesenteric injury. Radiographics. 2017;37:313–62.

    Article  Google Scholar 

  12. Elton C, Riaz AA, Young N, et al. Accuracy of computed tomography in the detection of blunt bowel and mesenteric injuries. Br J Surg. 2005;92:1024–8.

    Article  CAS  Google Scholar 

  13. Tan K-K, Liu JZ, Go T-S, et al. Computed tomography has an important role in hollow viscus and mesenteric injuries after blunt abdominal trauma. Injury. 2010;41:475–8.

    Article  Google Scholar 

  14. Petrosoniak A, Engels PT, Hamilton P, et al. Detection of significant bowel and mesenteric injuries in blunt abdominal trauma with 64- slice computed tomography. J Trauma Acute Care Surg. 2013;74:1081–6.

    Article  Google Scholar 

  15. Landry BA, Patlas MN, Faidi S, et al. Are we missing bowel and mesenteric injuries? Can Assoc Radiol J. 2016;67(4):420–5.

    Article  Google Scholar 

  16. Lawson CM, Daley BJ, Ormsby CB, Enderson B. Missed injuries in the era of the trauma scan. J Trauma. 2011;70:452–8.

    PubMed  Google Scholar 

  17. EurinM HN, Zappa M, et al. Incidence and predictors of missed injuries in trauma patients in the initial hot report of whole-body CT scan. Injury. 2012;43:73–7.

    Article  Google Scholar 

  18. Lannes F, Scemama U, Maignan A, et al. Value of early repeated abdominal CTin selective non-operative management for blunt bowel and mesenteric injury. Eur Radiol. 2019;29(11):5932–40.

    Article  CAS  Google Scholar 

  19. Tsang BD, Panacek EA, Brant WE, et al. Effect of oral contrast administration for abdominal computed tomography in the evaluation of acute blunt trauma. Ann Emerg Med. 1997;30:7–13.

    Article  CAS  Google Scholar 

  20. Lee CH, Haaland B, Earnest A, Tan CH. Use of positive oral contrast agents inabdominopelvic computed tomography for blunt abdominal injury: meta- analysis and systematic review. Eur Radiol. 2013;23(9):2513–21.

    Article  Google Scholar 

  21. Steenburg SD, Petersen MJ, Shen C, et al. Multi-detector CT of blunt mesenteric injuries: usefulness of imaging findings for predicting surgically significant bowel injuries. Abdom Imaging. 2015;40:1026–33.

    Article  Google Scholar 

  22. Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology. 2012;265:678–92.

    Article  Google Scholar 

  23. Faget C, Taourel P, Charbit J, et al. Value of CT to predict surgically important bowel and/or mesenteric injury in blunt trauma: performance of a preliminary scoring system. Eur Radiol. 2015;25:3620–8.

    Article  Google Scholar 

  24. LeBedis CA, Anderson SW, Bates DDB, et al. CT imaging signs of surgically proven bowel trauma. Emerg Radiol. 2016;23:213–9.

    Article  Google Scholar 

  25. Pouli S, Kozana A, Papakitsou I. Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology. Insights Imaging. 2020;11:31.

    Article  Google Scholar 

  26. Brody JM, Leighton DB, Murphy BL, et al. CT of blunt trauma bowel and mesenteric injury: typical findings and pitfalls in diagnosis. Radiographics. 2000;20:1525–36.

    Article  CAS  Google Scholar 

  27. Lubner M, Demertzis J, Lee JY, et al. CT evaluation of shock viscera: a pictorial review. Emerg Radiol. 2008;15:1–11.

    Article  CAS  Google Scholar 

  28. Wortman JR, Uyeda JW, Fulwadhva UP, Sodickson AR. Dual-energy CT for abdominal and pelvic trauma. Radiographics. 2018;38:586–602.

    Article  Google Scholar 

  29. Gamanagatti S, Rangarajan K, Kumar A. Blunt abdominal trauma: imaging and intervention. Curr Probl Diagn Radiol. 2015;44:321–36.

    Article  Google Scholar 

  30. Alabousi M, Mellnick VM, Al-Ghetaa RK, Patlas MN. Imaging of blunt bowel and mesenteric injuries: current status. Eur J Radiol. 2020;125:108894.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti, Chieti, Italy

    Raffaella Basilico, Andrea Delli Pizzi, Alessio Taraschi, Barbara Seccia & Roberta Cianci

Authors
  1. Raffaella Basilico
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Delli Pizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alessio Taraschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Barbara Seccia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roberta Cianci
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiology, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada

    Michael N Patlas

  2. Department of Radiology, NYU Winthrop Hospital, Mineola, NY, USA

    Douglas S. Katz

  3. Department of Radiology, Pineta Grande Hospital, Castel Volturno, Italy

    Mariano Scaglione

Section Editor information

  1. Cardiothoracic Imaging, Mallinckrodt Institute of Radiology, St. Louis, Missouri, USA

    Vincent Mellnick MD

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Basilico, R., Pizzi, A.D., Taraschi, A., Seccia, B., Cianci, R. (2021). Imaging of Blunt Bowel and Mesenteric Injuries. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-44092-3_23-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-44092-3_23-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44092-3

  • Online ISBN: 978-3-030-44092-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation