Abstract

Background
Contrast-enhanced Abdominopelvic Computed Tomography(CT) is widely used for diagnosing abdominal injuries after blunt trauma. The purpose of this retrospective study is to classify the contrast-enhanced Abdominopelvic CT finding of mesenteric injuries after blunt abdominal trauma and assess of CT finding on clinical management. Methods: Between January 2000 and December 2003, 607 consecutive spiral abdomonopelvic CT examinations were performed in the ER of Gil medical center after blunt abdominal trauma. CT represented mesenteric injuries : bowel wall thickening or hematoma, mesenteric haziness or fatty infiltration, confined fluid or hematoma within mesenteric folds. We classified patients into 5 Grade by the hematoma size on CT scans : Grade I(None, 0 mm), II(Minimal, ≤10 mm), III(Small, 11~30mm), IV(Moderate, 31~60 mm), V(Large, ≥61 mm). Results: On the basis of the CT findings, 42 of the 607 patients were selected. 18 (42.9%) of 42 patients were classified as having grade I, II, III (≤30 mm) and 24 (57.1%) of 42 patients as having grade IV, V(≥31 mm). Of the 18 patients with grade I, II, III, 16(88.9%) were managed conservatively, while 2(11.1%) underwent surgery. of the 24 patients with grade IV, V injuries, 20(83.3%) were treated surgically and 4(16.7%) patients were managed conservatively. Conclusions: It is sufficient to treat of grade I, II, III mesenteric injuries by conservative man-agement. It should be considered emergency operation to treatment of grade IV, V mesnteric injuries. (p<0.001) There were no relations between grading and initial systolic blood pressure, initial blood pressure and operation.

• Keywords: Blunt abdominal trauma, Abdominopelvic CT scan, Mesenteric injury