Significant blunt bowel and mesenteric injury - Comparison of two CT scoring systems in a trauma registry cohort.
AAWI, Anterior abdominal wall injury
AMB, Active mesenteric bleeding
ATMV, Abrupt termination of mesenteric vessels
BIPS, Bowel Injury Prediction Score
BWD, Bowel wall discontinuity
BWT, Bowel wall thickening
CT, Multidetector computed tomography
DBWE, Decreased bowel wall enhancement
FF, (Non-haematic) free fluid
FPP, Free pneumoperitoneum
HP, Haemoperitoneum
IBMV, Irregular beading of mesenteric vessels
Intestine, large
Intestine, small
MFS, Mesenteric (pericolic) fat stranding
MPP, Mesenteric pneumoperitoneum
Mesentery
Multidetector computed tomography
Polytrauma
SB, Small bowel
WBC, White blood cell
sBBMI, Significant blunt bowel and mesenteric injury
Journal
European journal of radiology open
ISSN: 2352-0477
Titre abrégé: Eur J Radiol Open
Pays: England
ID NLM: 101650225
Informations de publication
Date de publication:
2021
2021
Historique:
received:
20
07
2021
revised:
20
09
2021
accepted:
26
09
2021
entrez:
14
10
2021
pubmed:
15
10
2021
medline:
15
10
2021
Statut:
epublish
Résumé
This study evaluated and compared two imaging-based scoring systems for the detection of significant blunt bowel and mesenteric injury (sBBMI) by emergency computed tomography (CT). We included all consecutive adult polytrauma patients admitted to our emergency department following a road traffic accident from January 2008 to June 2015, provided that intravenously contrast-enhanced whole-body CT examination was performed immediately after hospital admission. Two radiologists, blinded to patients' outcome, reviewed the CT examinations for distinctive direct intestinal or mesenteric vascular injury and indirect signs of abdominal injury. These findings were correlated with the patients' surgical or interventional radiology findings, autopsy, or clinical follow-up (>24 h). Two previously validated imaging-based bowel-injury scoring systems, the CT-based Faget score and the clinically and radiologically based Mc Nutt score (BIPS), were compared by applying each to our trauma cohort. Student t-test, chi-squared, and logistic regression were used in analyses. Twenty-one of 752 analysed patients (2.8 %) had confirmed sBBMI. Active mesenteric bleeding, mesenteric and free pneumoperitoneum, small haemoperitoneum, non-focal bowel wall thickening, mesenteric/pericolic fat stranding, and anterior abdominal wall injury were significantly correlated with sBBMI, as did the two evaluated scoring systems (p < 0.001). However, multivariate logistic regression revealed the superiority of the Faget score to the McNutt score. The prevalence of sBBMI among polytrauma patients is low. Early diagnosis is necessary to avoid increased mortality. Certain CT features are pathognomic of sBBMI and must not be overlooked. Scoring systems are helpful, especially when they are based on radiological signs.
Identifiants
pubmed: 34646913
doi: 10.1016/j.ejro.2021.100380
pii: S2352-0477(21)00060-5
pmc: PMC8496098
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100380Informations de copyright
© 2021 The Author(s).
Déclaration de conflit d'intérêts
The authors declare that they have no potential conflicts of interest regarding this study.
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