Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US
| Autor: | John R. Richards, Payam Tabar, John P. McGahan, Jamie L. Simpson |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Physical examination Sensitivity and Specificity Humans Medicine Mesentery Radiology Nuclear Medicine and imaging Prospective Studies Ultrasonography medicine.diagnostic_test business.industry Gallbladder Surgery Intestines medicine.anatomical_structure Blunt trauma Concomitant Abdomen Female Radiology Emergencies business Pancreas Complication |
| Zdroj: | Radiology. 211:399-403 |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | To assess emergency ultrasonography (US) for detection of bowel and mesenteric injury from blunt trauma.For 3 years, prospective data on all patients undergoing emergency US were recorded. Patients with bowel and mesenteric injury were identified, and physical examination, laboratory, computed tomographic (CT), and intraoperative findings were compared with prospective data.From January 1995 to January 1998, emergency US was performed in 1,686 patients; 71 patients had bowel and mesenteric injury. Forty-one examinations were true-positive (i.e., with free fluid), and 30 were false-negative. Twenty-five of the 41 patients with true-positive US results had concomitant injuries that may have accounted for the free fluid, including liver, spleen, pancreas, gallbladder, kidney, and/or bladder injuries. The remaining 16 patients had isolated bowel and mesenteric injury. Bowel and mesenteric damage was identified intraoperatively in 70 patients. Twenty-nine of 30 patients with false-negative US examinations had abdominal tenderness. Sixteen patients with false-negative US results had bowel and mesenteric injury that was detected 12 or more hours after initial scanning.Free fluid in the abdomen is not detected in the majority of patients with isolated bowel and mesenteric injury. For clinical suspicion of bowel and mesenteric injury, observation, serial physical abdominal examination, and CT may be helpful in diagnosing this condition. |
| Databáze: | OpenAIRE |
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