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European Journal of Trauma and Emergency Surgery

Published in:

01-06-2016 | Review Article

Blunt abdominal trauma and mesenteric avulsion: a systematic review

Authors: A. Kordzadeh, V. Melchionda, K. M. Rhodes, E. O. Fletcher, Y. P. Panayiotopolous

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2016

Abstract

Purpose

The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on their overall management.

Materials and methods

A systematic review of literature in MedLine, Embase, Scopus and CINHAL in English language from 1951 to November 2014 was performed. A total of 20 reported cases were identified. Variables including patient’s demographics, signs and symptoms, mechanism of injury, investigative modality, management, length of stay, follow-up and outcomes were reviewed and analyzed.

Results

The median age of the cohort was 28.5 years (range 10–58 years), with a male-to-female ratio of 3:1. The commonest mechanism of injury was road traffic accident due to seat belt restraint (n = 12, 60 %). The commonest presentation was diffuse abdominal tenderness (n = 10, 45 %) followed by ecchymosis/bruising (n = 9, 40 %). Computed tomography (CT) remained the investigative modality of choice (n = 9, 45 %). All cases had an emergency exploratory laparotomy (n = 18, 90 %) within the initial 24 h and the median length of stay was 19 days (range 4–90 days). The overall mortality was 15 % (n = 3).

Conclusion

Mesenteric avulsion is rare and has a complex and vague presentation. Due to its potential mortality and morbidity, emergency physicians should keep a high index of suspicion in individuals with blunt abdominal trauma from any mechanism of injury.

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Title: Blunt abdominal trauma and mesenteric avulsion: a systematic review
Authors: A. Kordzadeh
V. Melchionda
K. M. Rhodes
E. O. Fletcher
Y. P. Panayiotopolous
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2016
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-015-0514-z

At a glance: The STEP trials

Springer Medicine

Blunt abdominal trauma and mesenteric avulsion: a systematic review

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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