Citation

Loftus TJ, Morrow ML, Lottenberg L, Rosenthal MD, Croft CA, Smith RS, Moore FA, Brakenridge SC, Borrego R, Efron PA, Mohr AM. Am. J. Surg. 2019; 218(2): 266-270.

Affiliation

University of Florida Health, Department of Surgery, Gainesville, FL, USA; University of Florida Health, Sepsis and Critical Illness Research Center, Gainesville, FL, USA. Electronic address: alicia.mohr@surgery.ufl.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2018.11.018

PMID

30509454

Abstract

BACKGROUND: Following blunt abdominal trauma, bowel injuries are often missed on admission computed tomography (CT) scan.

METHODS: Multicenter retrospective analysis of 176 adults with moderate-critical blunt abdominal trauma and admission CT scan who underwent operative exploration. Patients with a bowel injury missed on CT (n = 36, 20%) were compared to all other patients (n = 140, 80%).

RESULTS: The missed injury group had greater incidence free fluid without solid organ injury on CT scan (44% vs. 25%, p = 0.038) and visceral adhesions (28% vs. 6%, p = 0.001). Independent predictors of missed bowel injury included prior abdominal inflammation (OR 3.74, 95% CI 1.37-10.18), CT evidence of free fluid in the absence of solid organ injury (OR 2.31, 95% CI 1.03-5.19) and intraoperative identification of visceral adhesions (OR 4.46, 95% CI 1.52-13.13).

CONCLUSIONS: Patients with visceral adhesive disease and indirect evidence of bowel injury on CT scan were more likely to have occult bowel injury.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

Adhesions; Bowel injury; Computed tomography; Surgery; Trauma