Mdct imaging of blunt traumatic bowel and colonic perforation

Abstract

The intestine represents the third most frequently involved structure in blunt abdominal trauma (BAT) after the liver and the spleen. Injuries of the small bowel and of the colon are relatively uncommon, being found in approximately 3–5% of patients undergoing laparotomy and in about 1% of patients evaluated with computed tomography. In the broad spectrum of intestinal injuries from BAT, small bowel and colonic perforations represent a significant condition for several reasons. Clinical assessment alone of patients with suspected intestinal injury from BAT is associated with unacceptable diagnostic delays. Prompt identification and proper classification of small bowel and colonic injuries by multidetector computed tomography represent crucial issues in the management of patients with BAT. Their prognosis is significantly influenced by a timely diagnosis in the cases requiring immediate surgical interventions. The radiologist may identify specific and nonspecific signs of traumatic bowel perforation, suggesting the opportunity of conservative treatment in the cases of mild and moderate, noncomplicated, or self-limiting injuries or addressing to surgery when necessary.