Radiologic Imaging of Traumatic Bowel and Mesenteric Injuries: A Comprehensive Up-to-Date Review.

Area of Science:

• Radiology
• Trauma Surgery
• Abdominal Imaging

Background:

• Diagnosing bowel and mesenteric trauma presents significant challenges for radiologists.
• Delayed diagnosis of these injuries leads to increased morbidity and mortality.
• Accurate differentiation between surgical and non-operative management is crucial.

Purpose of the Study:

• To enhance radiologist awareness and diagnostic accuracy for bowel and mesenteric injuries.
• To provide an overview of common injuries, imaging evaluation, and CT findings.
• To identify diagnostic pearls and pitfalls in trauma abdominal CT.

Main Methods:

• Review of common bowel and mesenteric injuries.
• Discussion of imaging evaluation strategies.
• Analysis of computed tomography (CT) appearances and diagnostic challenges.

Main Results:

• Bowel and mesenteric injuries are frequently overlooked on trauma abdominal CT, with up to 40% of surgical injuries missed preoperatively.
• Subtle CT appearances, rarity, and limited radiologist awareness contribute to missed diagnoses.
• Enhanced diagnostic awareness is key to improving preoperative diagnostic yield.

Conclusions:

• Improving radiologist awareness and diagnostic skills for bowel and mesenteric trauma is essential.
• Accurate preoperative diagnosis via CT can optimize patient management, reduce costs, and improve survival.
• This review aims to reduce missed diagnoses and improve outcomes for patients with abdominal trauma.