RESUMEN
Two cases of blunt mesenteric injury were presented. In both cases, contrast-enhanced CT of the abdomen showed contrast extravasation in the intraperitoneal cavity (indicating injury of the superior mesenteric artery), bowel Wall thickening, hemoperitoneum and mesenteric hematoma. Under impression of mesenteric injury, emergency laparotomy was performed in both of the patients: two lacerations of the jejunal mesentery were identified in patient I and one laceration of the ileal mesentery was found in patient 2. Bowel resection was carried out in both of the patients. The course was uneventful during the 12 days and 11 days of hospitalization for patients 1 and 2 respectively
RESUMEN
Computed tomography (CT) is currently the diagnostic modality of choice in the evaluation of clinically stable patients with blunt abdominal trauma, including the assessment of blunt bowel and mesenteric injuries. CT signs of bowel and/or mesenteric injuries are bowel wall defect, free air, oral contrast material extravasation, extravasation of contrast material from mesenteric vessels, mesenteric vascular beading, abrupt termination of mesenteric vessels, focal bowel wall thickening, mesenteric fat stranding, mesenteric haematoma and intraperitoneal or retroperitoneal fluid. This pictorial essay illustrates CT features of bowel and/or mesenteric injuries in patients with blunt abdominal trauma. Pitfalls in interpretation of images are emphasized in proven cases.
RESUMEN
We report a case of posttraumatic intestinal stenosis (PIS), an uncommon sequela of blunt abdominal trauma, in which injury to the mesentery and bowel wall results in later focal ischemic stricture of that segment. We present CT images at the time of trauma and 3 weeks later when clinical signs of intestinal obstruction occurred. At surgery, a stenotic small bowel loop was found adjacent to a healed defect in the mesentery. Histologic examination of the resected segment showed mucosal and submucosal ischemia with mucosal ulceration, mural inflammation, and fibrosis. PIS subsequent to a mesenteric tear should be included in the differential diagnosis for a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.