Changes in the intestines and mesentery after blunt abdominal trauma as seen on the abdominal CT scan can be graded.
Patient selection: blunt abdominal trauma
Parameters:
(1) appearance of mesentery
(2) appearance of bowel wall in the small intestine
(3) other findings
Mesentery |
Small Intestine |
Other Findings |
Grade |
no changes |
no changes |
none |
0 |
isolated contusion |
no changes |
none |
1 |
hematoma < 5 cm in diameter |
no changes |
none |
2 |
hematoma >= 5 cm in diameter |
no changes |
none |
3 |
contusion or hematoma |
+/- bowel wall thickening |
+/- adjacent interloop fluid collection |
4 |
NA |
NA |
blood and/or contrast extravasation |
5 |
NA |
NA |
pneumoperitoneum |
5 |
Mesentery contusion: ill-defined, ground glass haziness; wispy or streaky opacities
A mesenteric hematoma appears as a discrete, measurable soft tissue density
Bowel wall thickening of the small bowel: > 3 mm
Interloop fluid collections are small triangular collections of free fluid within the mesentery or between bowel loops.
Specialty: Emergency Medicine, Surgery, orthopedic