RadioGraphics 2006; 26:1119–1131

Evaluation of Bowel and Mesenteric Blunt Trauma with Multidetector CT

Evaluation of Bowel and Mesenteric Blunt Trauma with Multidetector CT

Findings Specific to Bowel InjuryBowel Wall DiscontinuityExtraluminal Contrast MaterialExtraluminal Air

Findings Less Specific to Bowel InjuryBowel Wall ThickeningAbnormal Bowel Wall EnhancementMesenteric Features

hypervascular thickened jejunum with a suspicious defect

extraluminal air

free air

free oral contrast material

Traumatic devascularization of the left kidney

Traumatic devascularization of the left kidney

thickened wall of the transverse colon with decreased enhancement

intraperitoneal areas of free contrast material

free air

intraperitoneal areas of free contrast material

retroperitoneal area of extraluminal contrast enhancement

thickening of the wall of the ascending colon with adjacent fat stranding

free air hematoma of the right oblique internus muscle

retroperitoneal air

pericecal fat stranding and thickening of lateroconal fascia

air in SMV

contrast enhancement of the duodenal diverticulum

decreased enhancement of small bowel

free fluid

mesenteric fat stranding

subcutaneous emphysema extending to the extraperitoneal space producing pseudopneumoperitoneum

Evaluation of Bowel and Mesenteric Blunt Trauma with Multidetector CT

Findings Specific to Mesenteric InjuryMesenteric ExtravasationMesenteric Vascular BeadingTermination of Mesenteric Vessels

Less Specific FindingsMesenteric InfiltrationMesenteric HematomaBowel Features

thickening of the intestinal wall

thickened cecal wall

posterior abdominal wall tear

thickened cecal wall

shock bowel

without flattening of IVC

high-attenuation foci of intraperitoneal fluid

hypervascular thickened jejunal loops

shock bowel

hypervascular thickened segments of small bowel

abdominal wall tear

mesenteric fat stranding

hypervascular thickened segments of small bowel

unenhanced small-bowel loops

hypervascular thickened segments of small bowel

defect in the proximal jejunum

mesenteric hematoma

bowel infarct

mesenteric extravasation thickening and hypervascularity of proximal jejunum

mesenteric hematoma

thickening and hypervascularity of proximal jejunum

mesenteric vessels injury

mesenteric vessels injury

lesser sac stranding

abrupt termination of left gastric artery

mesenteric hematoma

abrupt termination of SMV

hematoma

Evaluation of Bowel and Mesenteric Blunt Trauma with Multidetector CT

Common Features in Bowel and Mesenteric InjuriesIntraperitoneal and Retroperitoneal FluidAbdominal Wall Injury

retroperitoneal hematoma

omental fat stranding

abdominal wall tear

mesenteric hematoma

normal appearance of the sigmoid colon