Liao Chien-Hung, Hsieh Feng-Jen, Chen Chih-Chi, Cheng Chi-Tung, Ooyang Chun-Hsiang, Hsieh Chi-Hsun, Yang Shang-Ju, Fu Chih-Yuan
Department of Trauma and emergency surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fuhsing St., Taoyuan 333, Taiwan.
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fuhsing St., Taoyuan 333, Taiwan.
J Clin Med. 2019 Aug 24;8(9):1300. doi: 10.3390/jcm8091300.
Delayed diagnosis and intervention of blunt bowel and mesenteric injury (BBMI) is a hazard because of poor prognosis. Computed tomography (CT) is the standard imaging tool to evaluate blunt abdominal trauma (BAT). However, a high missed diagnosis rate for BMMI was reported. In this study, we would like to evaluate the presentation of CT in BBMI. Moreover, we want to evaluate the impact of deferred surgical intervention of BBMI on final prognosis. We performed a retrospective study from 2013-2017, including patients with BAT and BBMI who underwent surgical intervention. We evaluated clinical characteristics, CT images, and surgical timing, as well as analyzed the prognosis of BBMI. There were 6164 BAT patients and 188 BMI patients included. The most common characteristics of CT were free fluid (71.3%), free air (43.6%), and mesenteric infiltration (23.4%). There were no single characteristics of a CT image that can predict BBMI significantly. However, under close monitoring, we find that deferred intervention did not prolong the hospital and intensive care unit stays and did not worsen the prognosis and mortality.
钝性肠及肠系膜损伤（BBMI）的诊断和干预延迟存在风险，因为其预后较差。计算机断层扫描（CT）是评估钝性腹部创伤（BAT）的标准影像学工具。然而，据报道BBMI的漏诊率较高。在本研究中，我们旨在评估CT在BBMI中的表现。此外，我们还想评估BBMI延迟手术干预对最终预后的影响。我们对2013年至2017年期间接受手术干预的BAT和BBMI患者进行了一项回顾性研究。我们评估了临床特征、CT图像和手术时机，并分析了BBMI的预后。共纳入6164例BAT患者和188例BMI患者。CT最常见的表现为腹腔游离液体（71.3%）、腹腔游离气体（43.6%）和肠系膜浸润（23.4%）。没有单一的CT图像特征能够显著预测BBMI。然而，在密切监测下，我们发现延迟干预并未延长住院时间和重症监护病房停留时间，也未使预后和死亡率恶化。
