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Imaging colorectal trauma using 64-MDCT technology

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Abstract

Computed tomography has evolved to become the principal imaging modality in the evaluation of colorectal trauma. Direct signs of colorectal trauma are usually highly specific but relatively insensitive and, therefore, indirect signs are important in the diagnostic of colorectal injuries. In addition, prompt recognition of colorectal injury is crucial as even short delays in its diagnosis have been shown to significantly increase both morbidity and mortality. All these things make colorectal injury a challenge for radiologists. The purpose of this review is to describe and analyze the various computed tomography (CT) findings of colorectal injuries in both penetrating and blunt trauma using 64-multirow detector computed tomography technology, based on our experience in a level I trauma center. Additionally, the CT protocol methods specific to colorectal injuries are detailed.

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References

  1. Dauterive AH, Flancbaum L, Cox EF (1985) Blunt intestinal trauma. A modern-day review. Ann Surg 201:198–203. doi:10.1097/00000658-198502000-00011

    Article  CAS  PubMed  Google Scholar 

  2. Fakhry SM, Brownstein M, Watts DD et al (2000) Relatively short diagnostic delays (<8 hours) produce morbidity and mortality in blunt small bowel injury: an analysis of time to operative intervention in 198 patients from a multicenter experience. J Trauma 48:408–414. doi:10.1097/00005373-200003000-00007

    Article  CAS  PubMed  Google Scholar 

  3. Kim HC, Shin HC, Park SJ et al (2004) Traumatic bowel perforation: analysis of CT findings according to the perforation site and the elapsed time since accident. Clin Imaging 28:334–339. doi:10.1016/S0899-7071(03)00244-4

    Article  PubMed  Google Scholar 

  4. Cleary RK, Pomerantz RA, Lampman RM (2006) Colon and rectal injuries. Dis Colon Rectum 49:1203–1222. doi:10.1007/s10350-006-0620-y

    Article  PubMed  Google Scholar 

  5. Pinedo-Onofre JA, Guevara-Torres L, Sánchez-Aguilar JM (2006) Penetrating abdominal trauma. Cir Cir 74:431–442

    PubMed  Google Scholar 

  6. Marx JA, Moore EE, Jorden RC et al (1985) Limitations of computed tomography in the evaluation of acute abdominal trauma: a prospective comparison with diagnostic peritoneal lavage. J Trauma 25:933–937

    Article  CAS  PubMed  Google Scholar 

  7. Sherck J, Shatney C, Sensaki K et al (1994) The accuracy of computed tomography in the diagnosis of blunt small-bowel perforation. Am J Surg 168:670–675. doi:10.1016/S0002-9610(05)80142-4

    Article  CAS  PubMed  Google Scholar 

  8. Tsang BD, Panacek EA, Brant WE et al (1997) Effect of oral contrast administration for abdominal computed tomography in the evaluation of acute blunt trauma. Ann Emerg Med 30:7–13. doi:10.1016/S0196-0644(97)70103-3

    Article  CAS  PubMed  Google Scholar 

  9. Atri M, Hanson JM, Grinblat L et al (2008) Surgically important bowel and/or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation. Radiology 249:524–533. doi:10.1148/radiol.2492072055

    Article  PubMed  Google Scholar 

  10. Elton C, Riaz AA, Young N et al (2005) Accuracy of computed tomography in the detection of blunt bowel and mesenteric injuries. Br J Surg 92:1024–1028. doi:10.1002/bjs.4931

    Article  CAS  PubMed  Google Scholar 

  11. Mitsuhide K, Junichi S, Atsushi N et al (2005) Computed tomographic scanning and selective laparoscopy in the diagnosis of blunt bowel injury: a prospective study. J Trauma 58:696–701. doi:10.1097/01.TA.0000159242.93309.F6

    Article  PubMed  Google Scholar 

  12. Shanmuganathan K, Mirvis SE, Chiu WC et al (2004) Penetrating torso trauma: triple-contrast helical CT in peritoneal violation and organ injury—a prospective study in 200 patients. Radiology 231:775–784. doi:10.1148/radiol.2313030126

    Article  CAS  PubMed  Google Scholar 

  13. Pinto A, Scaglione M, Pinto F et al (2000) Helical computed tomography diagnosis of gastrointestinal perforation in the elderly patient. Emerg Radiol 7:259–262. doi:10.1007/PL00011837

    Article  Google Scholar 

  14. Butela ST, Federle MP, Chang PJ et al (2001) Performance of CT in detection of bowel injury. AJR Am J Roentgenol 176:129–135

    CAS  PubMed  Google Scholar 

  15. Scaglione M, de Lutio di Castelguidone E, Scialpi M et al (2004) Blunt trauma to the gastrointestinal tract and mesentery: is there a role for helical CT in the decision-making process? Eur J Radiol 50:67–73. doi:10.1016/j.ejrad.2003.11.016

    Article  PubMed  Google Scholar 

  16. Miki T, Ogata S, Uto M et al (2004) Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall. Abdom Imaging 29:658–662. doi:10.1007/s00261-003-0159-y

    Article  CAS  PubMed  Google Scholar 

  17. Stuhlfaut JW, Soto JA, Lucey BC et al (2004) Blunt abdominal trauma: performance of CT without oral contrast material. Radiology 233(3):689–694. doi:10.1148/radiol.2333031972

    Article  PubMed  Google Scholar 

  18. Stafford RE, McGonigal MD, Weigelt JA et al (1999) Oral contrast solution and computerized tomography for blunt abdominal trauma: a randomized study. Arch Surg 134:622–627. doi:10.1001/archsurg.134.6.622

    Article  CAS  PubMed  Google Scholar 

  19. Allen TL, Mueller MT, Bonk RT et al (2004) Computed tomographic scanning without oral contrast solution for blunt bowel and mesenteric injuries in abdominal trauma. J Trauma 56:314–322. doi:10.1097/01.TA.0000058118.86614.51

    Article  PubMed  Google Scholar 

  20. Halvorsen RA Jr, McKenney K (2002) Blunt trauma to the gastrointestinal tract: CT findings with small bowel and colon injuries. Emerg Radiol 9:141–145

    PubMed  Google Scholar 

  21. Brofman N, Atri M, Hanson JM et al (2006) Evaluation of bowel and mesenteric blunt trauma with multidetector CT. Radiographics 26:1119–1131. doi:10.1148/rg.264055144

    Article  PubMed  Google Scholar 

  22. Brody JM, Leighton DB, Murphy BL et al (2000) CT of blunt trauma bowel and mesenteric injury: typical findings and pitfalls in diagnosis. Radiographics 20:1525–1537

    CAS  PubMed  Google Scholar 

  23. Malhotra AK, Fabian TC, Katsis SB et al (2000) Blunt bowel and mesenteric injuries: the role of screening computed tomography. J Trauma 48:991–998. doi:10.1097/00005373-200006000-00001

    Article  CAS  PubMed  Google Scholar 

  24. Livingston DH, Lavery RF, Passannante MR et al (2001) Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. Am J Surg 182:6–9. doi:10.1016/S0002-9610(01)00665-1

    Article  CAS  PubMed  Google Scholar 

  25. Drasin TE, Anderson SW, Asandra A et al (2008) MDCT evaluation of blunt abdominal trauma: clinical significance of free intraperitoneal fluid in males with absence of identifiable injury. AJR Am J Roentgenol 191:1821–1826. doi:10.2214/AJR.07.3347

    Article  PubMed  Google Scholar 

  26. Maxwell RA, Fabian TC (2003) Current management of colon trauma. World J Surg 27:632–639. doi:10.1007/s00268-003-6762-9

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Boston University Medical Center, 715 Albany Street, FGH-3007, Boston, MA, USA

    Stephan W. Anderson, James T. Rhea & Jorge A. Soto

  2. Department of Radiology, Clínica Universidad de Navarra, Avda Pio XII, 36, 31008, Pamplona, Spain

    Jose M. Bondia

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  1. Jose M. Bondia
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  2. Stephan W. Anderson
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  3. James T. Rhea
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  4. Jorge A. Soto
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Correspondence to Jose M. Bondia.

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Bondia, J.M., Anderson, S.W., Rhea, J.T. et al. Imaging colorectal trauma using 64-MDCT technology. Emerg Radiol 16, 433–440 (2009). https://doi.org/10.1007/s10140-009-0810-1

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  • DOI: https://doi.org/10.1007/s10140-009-0810-1

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