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Helical computed tomography of bowel and mesenteric injuries
K L Killeen1, K Shanmuganathan, P A Poletti
1Department of Diagnostic Radiology, University of Maryland Medical System and Shock Trauma Center, Baltimore, Maryland 21201-1595, USA.
The Journal of Trauma
|July 27, 2001
Summary
Helical computed tomography (CT) is highly accurate for diagnosing blunt abdominal trauma injuries to the bowel and mesentery. While effective for bowel injuries, CT is less precise in determining surgical necessity for mesenteric injuries alone.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Abdominal Injury
Background:
- The diagnostic accuracy of computed tomography (CT) for hollow viscus injury following blunt abdominal trauma is debated.
- Previous research shows conflicting results regarding CT's effectiveness.
Purpose of the Study:
- To evaluate the diagnostic accuracy of helical CT in identifying bowel and mesenteric injuries after blunt abdominal trauma.
- To assess CT's role in determining the need for surgical intervention in these injuries.
Main Methods:
- Retrospective analysis of 150 patients with diagnosed bowel or mesenteric injury.
- Comparison of CT scan findings with surgical outcomes.
- Grading of CT and surgical findings as negative, nonsurgical, or surgical.
Main Results:
- Helical CT demonstrated 94% sensitivity for bowel injury and 96% for mesenteric injury.
- CT correctly identified surgical bowel injury in 86% of cases.
- CT differentiated nonsurgical from surgical mesenteric injury in 75% of cases.
Conclusions:
- Helical CT scanning is a highly accurate tool for detecting bowel and mesenteric injuries.
- CT is effective in guiding surgical decisions for bowel injuries.
- CT's accuracy in predicting surgical necessity for isolated mesenteric injuries is lower.