Jejunum and ileum blunt trauma: what has changed with the implementation of multislice computed tomography?

Revista do Colégio Brasileiro de Cirurgiões

Raquel Oliveira Menna Barreto De Araújo¹  Marina Pimentel De Matos¹  Thiago José Penachim¹  Bruno Monteiro Tavares Pereira¹  Mario Eduardo De Faria Mantovani¹  Sandro Rizoli¹  Gustavo Pereira Fraga¹ 

关键词: Trauma;    Abdominal Injuries;    Intestine;    Small;    Computed Tomography;    Trauma;    Traumatismos Abdominais;    Intestino Delgado;    Tomografia Computadorizada;   

DOI  :  10.1590/0100-699120140040010

来源: SciELO

【 摘 要 】

OBJECTIVE: to evaluate the impact of the new technology of multidetector computed tomography (MDCT) in improving the accuracy and early diagnosis of BSBI.METHODS: patients with blunt small bowel injuries (BSBI) grade> I were identified retrospectively and their CT scans reviewed by an experienced radiologist. Clinical and tomographic findings were analyzed and patients grouped as "pre-MDCT" and "post-MDCT", according to the time of implementation of a 64-slice MDCT.RESULTS: of the 26 patients with BSBI 16 had CT scans. Motor vehicle collision (62.5%) was the most frequent mechanism of injury. In the pre-MDCT period, five of the 13 patients (38.5%) had abdominal CT, and in the post-MDCT, 11 of 13 patients (84.6%) had the exam. During pre-MDCT, all CT scans were abnormal with findings of pneumoperitoneum (60%), free fluid (40%) and bowel wall enhancement (20%). In the post-MDCT group, all exams but one were abnormal and the most frequent findings were free fluid (90.9%), bowel wall enhancement (72.7%), and pneumoperitoneum (54.5%). However, the rate of delayed laparotomy did not change. The mortality rate in both groups were similar, with 20% during pre-MDCT and 18.2% during post-MDCT.CONCLUSION: the use of MDCT in abdominal trauma in our service has increased the sensibility of the diagnosis, but has had no impact on outcome so far.

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