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World Journal of Surgery

Published in:

01-04-2013

Blunt Hollow Viscus and Mesenteric Injury: Still Underrecognized

Authors: Kazuhide Matsushima, Patricia S. Mangel, Eric W. Schaefer, Heidi L. Frankel

Published in: World Journal of Surgery | Issue 4/2013

Abstract

Background

Despite the availability of more accurate imaging modalities, specifically multidetector computed tomography (MDCT), the diagnosis of non-ischemic (NI-) and ischemic (I-) blunt hollow viscus and mesenteric injury (BHVMI) remains challenging. We hypothesized that BHVMI can be still missed with newer generations of MDCT and that patients with I-BHVMI have a poorer outcome than those with NI-BHVMI.

Methods

We performed an eight-year retrospective review at a level 1 trauma center. Ischemic-BHVMI was defined as devascularization confirmed at laparotomy. Non-ischemic-BHVMI included perforation, laceration, and hematoma without devascularization. The sensitivity of each generation of MDCT for BHVMI was calculated. Potential predictors and outcomes of I-BHVMI were compared to the NI-BHVMI group.

Results

Of 7,875 blunt trauma patients, 67 patients (0.8 %) were included in the BHVMI group; 13 patients did not have any CT findings suggestive of BHVMI (sensitivity 81 %), and 11 of them underwent surgical intervention without delay (<5 h). Newer generations of MDCT were not associated with higher sensitivity. Patients with I-BHVMI had a significantly higher rate of delayed laparotomy ≥12 h (23 % versus 2 %; p = 0.01) and a significantly longer length of hospital stay (median 14 versus 9 days; p = 0.02) than those with NI-BHVMI.

Conclusions

Even using an advanced imaging technique, the diagnosis of I-BHVMI can be delayed, with significant negative impact on patient outcome.

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Title: Blunt Hollow Viscus and Mesenteric Injury: Still Underrecognized
Authors: Kazuhide Matsushima
Patricia S. Mangel
Eric W. Schaefer
Heidi L. Frankel
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 4/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1896-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Blunt Hollow Viscus and Mesenteric Injury: Still Underrecognized

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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