Value of multi-detector computed tomography in the diagnosis of blunt bowel and mesenteric injuries

Abstract

Purpose: The purpose of this study was to evaluate the role of MDCT in detecting and predicting blunt bowel and mesenteric injuries. Materials and methods: This is a retrospective observational study of 66 patients (54 males, 12 females, average age of 45.5 years) who underwent laparotomy at Nghe An Friendship General Hospital between April 2020 and August 2021 with a diagnosis of bowel and/or mesenteric injuries in blunt abdominal trauma. All of these patients had a contrast-enhanced MDCT prior to surgery. All CT findings were documented and calculated for their diagnostic performance compared to surgical outcomes. Results: The most common finding was mesenteric infiltration (75.8%), followed by bowel wall thickening (63.6%). Bowel wall discontinuity had the highest specificity and positive predictive value of 100%. The most sensitive signs were free air 81.6%, mesenteric infiltration 79.7%. The specificity of bowel hypoenhancement and mesenteric vessel abnormalities were highest at 92.3% and 98.1%, respectively. Bowel wall thickening, bowel wall hypoenhancement, mesenteric vessel abnormalities, and free air had strongest association with blunt bowel and/or mesenteric injury requiring surgery (OR = 5.7, 51, 68 and 14.4, respectively). Conclusion: The multi-detector computed tomography provides high-specificity important findings indicating bowel and mesenteric injuries necessitating surgery. Key words: bowel and mesenteric injury, gastrointestinal tract injury, blunt abdominal trauma, computed tomography.