Mesh : Abdominal Injuries / diagnostic imaging Accidents, Traffic Adolescent Adult Aged Contrast Media Female Humans Intestines / blood supply diagnostic imaging injuries Iohexol London Male Mesentery / blood supply diagnostic imaging injuries Middle Aged Radiographic Image Enhancement / methods Tomography, X-Ray Computed / methods Vascular System Injuries / diagnostic imaging Wounds, Nonpenetrating / diagnostic imaging Young Adult

来  源:   DOI:10.1016/j.crad.2020.09.022   PDF(Sci-hub)

Abstract:
OBJECTIVE: To establish common patterns of injury in vascular bowel and mesenteric injury (VBMI) and to identify any factors that may lead to delayed treatment.
METHODS: Forty-one patients with blunt VBMI presented to the level 1 trauma centre of the The Royal London Hospital over 5 years. Computed tomography (CT) images were reviewed to identify the specific location of injury and additional features such as seatbelt bruising and lumbar hernias. Surgical reports were reviewed to record any pertinent surgical findings at laparotomy.
RESULTS: The commonest mechanism of injury was a restrained car occupant involved in a road traffic collision (49%, n=20). The ileocaecal mesenteric vasculature was most frequently injured (41.5%, n=17), followed by the mid ileum (17.1%, n=7). Seatbelt bruising was identified in 80% of restrained car occupants and lumbar hernias in 22% of all patients with VBMI.
CONCLUSIONS: Restrained car occupants involved in road traffic collisions are at increased risk of VBMI with particular susceptibility of the ileocaecal mesentery. This has implications for the reporting radiologist and trauma surgeon in deciding which patients require careful monitoring for the development of delayed bowel ischaemia.
摘要:
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