Blunt bowel and mesenteric injury : Diagnostic performance of CT signs
Our goal was to determine the sensitivity and specificity of various CT signs of blunt bowel and mesenteric injury. The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group...
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| Veröffentlicht in: | Journal of computer assisted tomography 1997-09, Vol.21 (5), p.706-712 |
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| description | Our goal was to determine the sensitivity and specificity of various CT signs of blunt bowel and mesenteric injury.
The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group consisted of 19 patients with surgically proven bowel and/or mesenteric injury. The control group consisted of 12 traumatized patients who had no bowel or mesenteric injury. The CT signs assessed were presence, location, and extent of intraperitoneal fluid, extraluminal air, bowel wall thickening, bowel wall discontinuity, mesenteric streaking, and mesenteric hematoma.
In the 12 cases of bowel injury (9 transmural injury, 3 partial thickness injury), the CT sign of bowel wall thickening had sensitivity of 50% and specificity of 84% and the CT sign of bowel wall discontinuity had sensitivity of 58% and specificity of 95%. Extraluminal air was a specific but relatively insensitive sign of transmural bowel injury (sensitivity 44%, specificity 100%). In the 13 patients with mesenteric injuries, the CT sign of mesenteric hematoma had sensitivity of 54% and specificity of 94%. Isolated mesenteric streaking was a less specific sign of mesenteric injury (sensitivity 77%, specificity 44%). The finding of peritoneal fluid with no visible solid organ injury was a useful sign of bowel or mesenteric injury, occurring in 11 of 19 (58%) study patients and none of the controls (p < 0.001).
Bowel wall thickening, bowel wall discontinuity, extraluminal air, and mesenteric hematoma are reasonably specific CT signs of bowel and mesenteric injury following blunt abdominal trauma. The presence of a moderate to large volume of intraperitoneal fluid without visible solid organ injury is an important sign of bowel or mesenteric injury. |
| doi_str_mv | 10.1097/00004728-199709000-00005 |
| format | Article |
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The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group consisted of 19 patients with surgically proven bowel and/or mesenteric injury. The control group consisted of 12 traumatized patients who had no bowel or mesenteric injury. The CT signs assessed were presence, location, and extent of intraperitoneal fluid, extraluminal air, bowel wall thickening, bowel wall discontinuity, mesenteric streaking, and mesenteric hematoma.
In the 12 cases of bowel injury (9 transmural injury, 3 partial thickness injury), the CT sign of bowel wall thickening had sensitivity of 50% and specificity of 84% and the CT sign of bowel wall discontinuity had sensitivity of 58% and specificity of 95%. Extraluminal air was a specific but relatively insensitive sign of transmural bowel injury (sensitivity 44%, specificity 100%). In the 13 patients with mesenteric injuries, the CT sign of mesenteric hematoma had sensitivity of 54% and specificity of 94%. Isolated mesenteric streaking was a less specific sign of mesenteric injury (sensitivity 77%, specificity 44%). The finding of peritoneal fluid with no visible solid organ injury was a useful sign of bowel or mesenteric injury, occurring in 11 of 19 (58%) study patients and none of the controls (p < 0.001).
Bowel wall thickening, bowel wall discontinuity, extraluminal air, and mesenteric hematoma are reasonably specific CT signs of bowel and mesenteric injury following blunt abdominal trauma. The presence of a moderate to large volume of intraperitoneal fluid without visible solid organ injury is an important sign of bowel or mesenteric injury.</description><identifier>ISSN: 0363-8715</identifier><identifier>EISSN: 1532-3145</identifier><identifier>DOI: 10.1097/00004728-199709000-00005</identifier><identifier>PMID: 9294556</identifier><identifier>CODEN: JCATD5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Abdominal Injuries - diagnostic imaging ; Abdominal Injuries - surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Air ; Ascitic Fluid - diagnostic imaging ; Biological and medical sciences ; Contrast Media ; Contusions - diagnostic imaging ; Digestive system ; Female ; Hematoma - diagnostic imaging ; Humans ; Intestines - diagnostic imaging ; Intestines - injuries ; Intestines - surgery ; Investigative techniques, diagnostic techniques (general aspects) ; Iothalamate Meglumine ; Kidney - diagnostic imaging ; Kidney - injuries ; Laparotomy ; Liver - diagnostic imaging ; Liver - injuries ; Male ; Medical sciences ; Mesentery - diagnostic imaging ; Mesentery - injuries ; Mesentery - surgery ; Middle Aged ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Retrospective Studies ; Rupture ; Sensitivity and Specificity ; Single-Blind Method ; Spleen - diagnostic imaging ; Spleen - injuries ; Tomography, X-Ray Computed ; Triiodobenzoic Acids ; Wounds, Nonpenetrating - diagnostic imaging ; Wounds, Nonpenetrating - surgery</subject><ispartof>Journal of computer assisted tomography, 1997-09, Vol.21 (5), p.706-712</ispartof><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-93354d65f7952d866b15549093a5d1f34afef0328f77747cc716a1ae6209d443</citedby><cites>FETCH-LOGICAL-c405t-93354d65f7952d866b15549093a5d1f34afef0328f77747cc716a1ae6209d443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2795841$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9294556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BREEN, D. J</creatorcontrib><creatorcontrib>JANZEN, D. L</creatorcontrib><creatorcontrib>ZWIREWICH, C. V</creatorcontrib><creatorcontrib>NAGY, A. G</creatorcontrib><title>Blunt bowel and mesenteric injury : Diagnostic performance of CT signs</title><title>Journal of computer assisted tomography</title><addtitle>J Comput Assist Tomogr</addtitle><description>Our goal was to determine the sensitivity and specificity of various CT signs of blunt bowel and mesenteric injury.
The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group consisted of 19 patients with surgically proven bowel and/or mesenteric injury. The control group consisted of 12 traumatized patients who had no bowel or mesenteric injury. The CT signs assessed were presence, location, and extent of intraperitoneal fluid, extraluminal air, bowel wall thickening, bowel wall discontinuity, mesenteric streaking, and mesenteric hematoma.
In the 12 cases of bowel injury (9 transmural injury, 3 partial thickness injury), the CT sign of bowel wall thickening had sensitivity of 50% and specificity of 84% and the CT sign of bowel wall discontinuity had sensitivity of 58% and specificity of 95%. Extraluminal air was a specific but relatively insensitive sign of transmural bowel injury (sensitivity 44%, specificity 100%). In the 13 patients with mesenteric injuries, the CT sign of mesenteric hematoma had sensitivity of 54% and specificity of 94%. Isolated mesenteric streaking was a less specific sign of mesenteric injury (sensitivity 77%, specificity 44%). The finding of peritoneal fluid with no visible solid organ injury was a useful sign of bowel or mesenteric injury, occurring in 11 of 19 (58%) study patients and none of the controls (p < 0.001).
Bowel wall thickening, bowel wall discontinuity, extraluminal air, and mesenteric hematoma are reasonably specific CT signs of bowel and mesenteric injury following blunt abdominal trauma. The presence of a moderate to large volume of intraperitoneal fluid without visible solid organ injury is an important sign of bowel or mesenteric injury.</description><subject>Abdominal Injuries - diagnostic imaging</subject><subject>Abdominal Injuries - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Air</subject><subject>Ascitic Fluid - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Contrast Media</subject><subject>Contusions - diagnostic imaging</subject><subject>Digestive system</subject><subject>Female</subject><subject>Hematoma - diagnostic imaging</subject><subject>Humans</subject><subject>Intestines - diagnostic imaging</subject><subject>Intestines - injuries</subject><subject>Intestines - surgery</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Iothalamate Meglumine</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - injuries</subject><subject>Laparotomy</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - injuries</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mesentery - diagnostic imaging</subject><subject>Mesentery - injuries</subject><subject>Mesentery - surgery</subject><subject>Middle Aged</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Retrospective Studies</subject><subject>Rupture</subject><subject>Sensitivity and Specificity</subject><subject>Single-Blind Method</subject><subject>Spleen - diagnostic imaging</subject><subject>Spleen - injuries</subject><subject>Tomography, X-Ray Computed</subject><subject>Triiodobenzoic Acids</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><subject>Wounds, Nonpenetrating - surgery</subject><issn>0363-8715</issn><issn>1532-3145</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1PwzAMhiMEGmPwE5ByQNwK-U7DDQYDpElcdq-yNJk6tclIWqH9ezJW5ovl1_Zr-QEAYvSAkZKPKAeTpCywUhKpXBUHiZ-BKeaUFBQzfg6miApalBLzS3CV0hYhLCllEzBRRDHOxRQsXtrB93AdfmwLta9hZ5P1vY2NgY3fDnEPn-Brozc-pD5rOxtdiJ32xsLg4HwFU7Px6RpcON0mezPmGVgt3lbzj2L59f45f14WhiHeF4pSzmrBnVSc1KUQa8w5U0hRzWvsKNPOOkRJ6aSUTBojsdBYW0GQqhmjM3B_tN3F8D3Y1Fddk4xtW-1tGFIlFSmRyHYzUB4HTQwpReuqXWw6HfcVRtWBYPVPsDoR_JN4Xr0dbwzrztanxRFZ7t-NfZ2Mbl3MLJp0GiP5tZJh-gvFzXao</recordid><startdate>19970901</startdate><enddate>19970901</enddate><creator>BREEN, D. J</creator><creator>JANZEN, D. L</creator><creator>ZWIREWICH, C. V</creator><creator>NAGY, A. G</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970901</creationdate><title>Blunt bowel and mesenteric injury : Diagnostic performance of CT signs</title><author>BREEN, D. J ; JANZEN, D. L ; ZWIREWICH, C. V ; NAGY, A. G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-93354d65f7952d866b15549093a5d1f34afef0328f77747cc716a1ae6209d443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Abdominal Injuries - diagnostic imaging</topic><topic>Abdominal Injuries - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Air</topic><topic>Ascitic Fluid - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Contrast Media</topic><topic>Contusions - diagnostic imaging</topic><topic>Digestive system</topic><topic>Female</topic><topic>Hematoma - diagnostic imaging</topic><topic>Humans</topic><topic>Intestines - diagnostic imaging</topic><topic>Intestines - injuries</topic><topic>Intestines - surgery</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Iothalamate Meglumine</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - injuries</topic><topic>Laparotomy</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - injuries</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mesentery - diagnostic imaging</topic><topic>Mesentery - injuries</topic><topic>Mesentery - surgery</topic><topic>Middle Aged</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Retrospective Studies</topic><topic>Rupture</topic><topic>Sensitivity and Specificity</topic><topic>Single-Blind Method</topic><topic>Spleen - diagnostic imaging</topic><topic>Spleen - injuries</topic><topic>Tomography, X-Ray Computed</topic><topic>Triiodobenzoic Acids</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><topic>Wounds, Nonpenetrating - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BREEN, D. J</creatorcontrib><creatorcontrib>JANZEN, D. L</creatorcontrib><creatorcontrib>ZWIREWICH, C. V</creatorcontrib><creatorcontrib>NAGY, A. G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of computer assisted tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BREEN, D. J</au><au>JANZEN, D. L</au><au>ZWIREWICH, C. V</au><au>NAGY, A. G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blunt bowel and mesenteric injury : Diagnostic performance of CT signs</atitle><jtitle>Journal of computer assisted tomography</jtitle><addtitle>J Comput Assist Tomogr</addtitle><date>1997-09-01</date><risdate>1997</risdate><volume>21</volume><issue>5</issue><spage>706</spage><epage>712</epage><pages>706-712</pages><issn>0363-8715</issn><eissn>1532-3145</eissn><coden>JCATD5</coden><abstract>Our goal was to determine the sensitivity and specificity of various CT signs of blunt bowel and mesenteric injury.
The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group consisted of 19 patients with surgically proven bowel and/or mesenteric injury. The control group consisted of 12 traumatized patients who had no bowel or mesenteric injury. The CT signs assessed were presence, location, and extent of intraperitoneal fluid, extraluminal air, bowel wall thickening, bowel wall discontinuity, mesenteric streaking, and mesenteric hematoma.
In the 12 cases of bowel injury (9 transmural injury, 3 partial thickness injury), the CT sign of bowel wall thickening had sensitivity of 50% and specificity of 84% and the CT sign of bowel wall discontinuity had sensitivity of 58% and specificity of 95%. Extraluminal air was a specific but relatively insensitive sign of transmural bowel injury (sensitivity 44%, specificity 100%). In the 13 patients with mesenteric injuries, the CT sign of mesenteric hematoma had sensitivity of 54% and specificity of 94%. Isolated mesenteric streaking was a less specific sign of mesenteric injury (sensitivity 77%, specificity 44%). The finding of peritoneal fluid with no visible solid organ injury was a useful sign of bowel or mesenteric injury, occurring in 11 of 19 (58%) study patients and none of the controls (p < 0.001).
Bowel wall thickening, bowel wall discontinuity, extraluminal air, and mesenteric hematoma are reasonably specific CT signs of bowel and mesenteric injury following blunt abdominal trauma. The presence of a moderate to large volume of intraperitoneal fluid without visible solid organ injury is an important sign of bowel or mesenteric injury.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9294556</pmid><doi>10.1097/00004728-199709000-00005</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of computer assisted tomography, 1997-09, Vol.21 (5), p.706-712 |
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| subjects | Abdominal Injuries - diagnostic imaging Abdominal Injuries - surgery Adolescent Adult Aged Aged, 80 and over Air Ascitic Fluid - diagnostic imaging Biological and medical sciences Contrast Media Contusions - diagnostic imaging Digestive system Female Hematoma - diagnostic imaging Humans Intestines - diagnostic imaging Intestines - injuries Intestines - surgery Investigative techniques, diagnostic techniques (general aspects) Iothalamate Meglumine Kidney - diagnostic imaging Kidney - injuries Laparotomy Liver - diagnostic imaging Liver - injuries Male Medical sciences Mesentery - diagnostic imaging Mesentery - injuries Mesentery - surgery Middle Aged Radiodiagnosis. Nmr imagery. Nmr spectrometry Retrospective Studies Rupture Sensitivity and Specificity Single-Blind Method Spleen - diagnostic imaging Spleen - injuries Tomography, X-Ray Computed Triiodobenzoic Acids Wounds, Nonpenetrating - diagnostic imaging Wounds, Nonpenetrating - surgery |
| title | Blunt bowel and mesenteric injury : Diagnostic performance of CT signs |
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