Diagnosis of bowel and mesenteric blunt trauma with multidetector CT

Y.-B. Shi, J.-M. Hao, C.-N. Hu, L.-N. Dou

Department of Diagnostic Imaging, Xuzhou Central Hospital, Xuzhou, China. ctsyb@163.com

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• Radiology

OBJECTIVE: To assess the examination methods, the multidetector CT (MDCT), and findings of bowel and mesenteric injuries in blunt trauma and the evaluation for clinical management.

PATIENTS AND METHODS: Retrospectively analysis examination methods, image reformation, the sensitivity and specificity of variant appearance in MDCT of 43 cases of bowel and mesenteric injuries which were conformed by operation.

RESULTS: Contrast enhancement thin CT with multi-plannar reconstruction MPR can improve the sensitivity of bowel and mesenteric injuries. Appearance of bowel and mesenteric injuries in MDCT included below: patchy or focal bowel wall thickening in 67.4%, intraperitoneal free air in 25.6%, mesenteric infiltration in 90.7%, and intraperitoneal fluid in 81.4%. Bowel wall discontinuity and intraperitoneal free air are specific to bowel injuries, whereas asymmetric bowel wall thickening, irregular enhancement of bowel wall, blurred serous membrane, and fluid of intestinal loop are strongly suggestive to bowel and mesenteric injuries.

CONCLUSIONS: Contrast enhancement thin CT with MPR can help improve to show direct and indirect sigh of bowel and mesenteric injuries with higher sensitivity and specificity.

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