장관 및 장간막 손상의 전산화단층촬영 소견

Abstract

Purpose : To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CTfindings and its usfulness in patients of abdominal trauma. Materials and Methods : CT scans of 27 patients whowere confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Ofthese 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed werebowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesentericinfiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury obly and withboth bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such asliver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. Results: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21(78%), highlyattenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10(37%) andsentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Twocases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant differencein the prevalence of the CT findings between the patient group with bowel injury only and the patient group withboth bowel and meseneric injury. Conclusion : CT scan is a useful tool in evaluating the degree and extent ofbowel and/or mesenteric injury as well as in planning the patients management.