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Journal of the Korean Society of Traumatology 2004;17(2):155-162.
Value of Contrast-enhanced CT for Evaluating Mesenteric Injuries after Blunt Trauma
Ki Cheul Noh, M.D., Jin Joo Kim, M.D., Jin Ho Jung, M.D., Yong Su Lim, M.D., Hyuk Jun Yang, M.D., Keun Lee, M.D., Uk Jin, M.D.*, Cheul Hee Park, M.D.*
Department of Emergency Medicine and Radiology*
Gachon Medical School, Gil Medical Center, Incheon, Korea
복부 둔상에 의한 장간막 손상 환자의 평가에서 복부단층촬영의 가치
노기철·김진주·정진호·임용수·양혁준·이근·진욱*·박철희*
가천의과대학교 길병원 응급의학과, 영상의학과*
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.
Key Words: Blunt abdominal trauma; Abdominopelvic CT scan; Mesenteric injury


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