Unenhanced Computed Tomography to Visualize Hollow Viscera and/or Mesenteric Injury After Blunt Abdominal Trauma A Single-Institution Experience

被引:4
作者
Yang, Xu-Yang [1 ]
Wei, Ming-Tian [1 ]
Jin, Cheng-Wu [2 ]
Wang, Meng [1 ]
Wang, Zi-Qiang [1 ]
机构
[1] Sichuan Univ, Dept Gastrointestinal Surg, West China Hosp, 37 Guo Xue Alley, Chengdu 610041, Sichuan, Peoples R China
[2] Fifth Peoples Hosp Chengdu, Dept Gastrointestinal Surg, Chengdu, Sichuan, Peoples R China
关键词
SMALL-BOWEL ISCHEMIA; MULTIDETECTOR CT; ORAL CONTRAST; PERFORMANCE; DIAGNOSIS; PERFORATION; GUIDELINES; MANAGEMENT; PITFALLS; TIME;
D O I
10.1097/MD.0000000000002884
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To identify and describe the major features of unenhanced computed tomography (CT) images of blunt hollow viscera and/or mesenteric injury (BHVI/MI) and to determine the value of unenhanced CT in the diagnosis of BHVI/MI. This retrospective study included 151 patients who underwent unenhanced CT before laparotomy for blunt abdominal trauma between January 2011 and December 2013. According to surgical observations, patients were classified as having BHVI/MI (n = 73) or not (n = 78). Sensitivity, specificity, P values, and likelihood ratios were calculated by comparing CT findings between the 2 groups. Six significant CT findings (P < 0.05) for BHVI/MI were identified and their sensitivity and specificity values determined, as follows: bowel wall thickening (39.7%, 96.2%), mesentery thickening (46.6%, 88.5%), mesenteric fat infiltration (12.3%, 98.7%), peritoneal fat infiltration (31.5%, 87.1%), parietal peritoneum thickening (30.1%, 85.9%), and intra- or retro-peritoneal air (34.2%, 96.2%). Unenhanced CT scan was useful as an initial assessment tool for BHVI/MI after blunt abdominal trauma. Six key features on CT were correlated with BHVI/MI.
引用
收藏
页数:7
相关论文
共 27 条
[1]   Delayed diagnosis of blunt duodenal injury: An avoidable complication [J].
Allen, GS ;
Moore, FA ;
Cox, CS ;
Mehall, JR ;
Duke, JH .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 1998, 187 (04) :393-399
[2]   ISCHEMIC OR INFARCTED BOWEL - CT FINDINGS [J].
ALPERN, MB ;
GLAZER, GM ;
FRANCIS, IR .
RADIOLOGY, 1988, 166 (01) :149-152
[3]   Surgically Important Bowel and/or Mesenteric Injury in Blunt Trauma: Accuracy of Multidetector CT for Evaluation [J].
Atri, Mostafa ;
Hanson, John M. ;
Grinblat, Lenny ;
Brofman, Nicole ;
Chughtai, Talat ;
Tomlinson, George .
RADIOLOGY, 2008, 249 (02) :524-533
[4]   CT of blunt trauma bowel and mesenteric injury: Typical findings and pitfalls in diagnosis [J].
Brody, JM ;
Leighton, DB ;
Murphy, BL ;
Abbott, GF ;
Vaccaro, JP ;
Jagminas, L ;
Gioffi, WG .
RADIOGRAPHICS, 2000, 20 (06) :1525-1536
[5]   Evaluation of bowel and mesenteric blunt trauma with multidetector CT [J].
Brofman, Nicole ;
Atri, Mostafa ;
Hanson, John M. ;
Grinblat, Leonard ;
Chughtai, Talat ;
Brenneman, Fred .
RADIOGRAPHICS, 2006, 26 (04) :1119-1131
[6]   Performance of CT in detection of bowel injury [J].
Butela, ST ;
Federle, MP ;
Chang, PJ ;
Thaete, FL ;
Peterson, MS ;
Dorvault, CJ ;
Hari, AK ;
Soni, S ;
Branstetter, BF ;
Paisley, KJ ;
Huang, LF .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (01) :129-135
[7]   Relatively short diagnostic delays (&lt;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].
Fakhry, SM ;
Brownstein, M ;
Watts, DD ;
Baker, CC ;
Oller, D .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2000, 48 (03) :408-414
[8]   Current diagnostic approaches lack sensitivity in the diagnosis of perforated blunt small bowel injury: Analysis from 275,557 trauma admissions from the EAST multi-institutional HVI trial [J].
Fakhry, SM ;
Watts, DD ;
Luchette, FA .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2003, 54 (02) :295-306
[9]   Blunt injury to mesentery and small bowel: CT evaluation [J].
Hanks, PW ;
Brody, JM .
RADIOLOGIC CLINICS OF NORTH AMERICA, 2003, 41 (06) :1171-+
[10]   Practice management guidelines for the evaluation of blunt abdominal trauma: The EAST practice management guidelines work group [J].
Hoff, WS ;
Holevar, M ;
Nagy, KK ;
Patterson, L ;
Young, JS ;
Arrillaga, A ;
Najarian, MP ;
Valenziano, CP .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2002, 53 (03) :602-615