Mural hematoma: discontinuity in the bowel wall with mural thickening (>3-4 mm) may be complete (i.e. In penetrating trauma, extra-luminal free gas is not specific to bowel perforation extra-luminal contrast media/bowel contents leak and a wound track extending to bowel is considered the most sensitive wall thickening/mesenteric contusion is less sensitive 2 In blunt trauma, the presence of extra-luminal oral contrast media (if used) or bowel contents extra-luminal free gas (especially in the absence of pneumothorax/ pneumomediastinum) 2 The mechanism of bowel injury include crush/compression type, shearing type (from fixed point of mesentery) and burst type (from increased intra-luminal pressure) and can include 4: Jejunum (near ligament of Treitz/D-J flexure)Ĭolon ( cecum, transverse colon, sigmoid colon) Typesįrom most to least common sites of bowel injury 1,4,6: Motor vehicle collisions are the most common cause of blunt trauma followed by falls, assaults and sports-related trauma 4,6. Gunshot wounds (~75%) and stabbings (~20%) are the leading causes of bowel and mesenteric injury from penetrating trauma 8. Bowel injury has consistently been found to be the most common traumatic abdominopelvic injury missed on CT 11. However not surprisingly, bowel and mesenteric injuries are more frequent after penetrating trauma 8.
![trauma sign trauma sign](https://newpath.org/wp-content/uploads/2022/07/Thumbnail.png)
![trauma sign trauma sign](https://ak1.ostkcdn.com/images/products/is/images/direct/8787f379661f75c1eef716dabac0f821b02d1c29/iCanvas-"I-Release-My-Trauma"-by-Brandie-Adams-Piphus-Framed.jpg)
The bowel and mesentery are injured in ~2.5% (range 0.3-5%) of blunt force abdominal trauma 1,3,5,8.