Abdominal trauma7/13/2023 CT of blunt trauma bowel and mesenteric injury: typical findings and pitfalls in diagnosis. Brody JM, Leighton DB, Murphy BL, Abbott GF, Vaccaro JP, Jagminas L, et al. CT findings of mesenteric injury after blunt trauma. Murakami R, Tajima H, Kumazaki T, Kobayashi Y. Other findings also include intra-abdominal fluid collections and pneumoperitoneum. The main findings can be divided into intestinal alterations resulting from ischemia, such as parietal thickening, decreased parietal enhancement, pneumatosis, and/or direct observation of the mesenteric injury, including filling defects, leakage of the contrast medium, mesenteric hematomas, and densification of adipose layers. The symptoms are generally non-specific, and not always reliable within the context of trauma. Intestinal Injury from blunt abdominal trauma: a study of 47 cases. It is believed that these cases result from deceleration forces, which lead to vascular strain, with rupture or mesenteric thrombosis and subsequent intestinal ischemia. Diagnosis and management of blunt abdominal trauma. ) In most cases, there is solid viscera involvement, especially spleen and liver and isolated lesions of the mesentery are rare. Surgical specimen photograph of right hemicolectomyīlunt abdominal trauma is a frequently found event in the context of emergencies, in which three fourths of cases result from automobile accidents. A new CT was performed 20 hours after the first, which revealed dilation and parietal thickening of the right colon, associated with a minimal pneumoperitoneum ( Figures 2 and 3 ). During the serial physical examination, persistence of abdominal pain was noted, with no signs of peritonitis. The patient was stabilized, and initially conservative treatment was chosen. The presumptive preoperative diagnosis was vascular mesenteric lesion due to straining. During secondary evaluation, abrasions were identified on the abdominal wall in the right flank area.ĭue to high energy trauma, he underwent a whole body computed tomography (CT) that showed an hematoma in the mesenteric fat planes of the abdomen, and also filling defects in branches of the middle colic artery ( Figure 1 ). He was hemodynamically stable, with no respiratory or neurological impairment, complaining of diffuse moderate intensity abdominal pain during the physical examination. A 34-year old male patient, victim of motorcycle accident at about 56 miles/hour, was brought into emergency care with a cervical collar.
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