Skip to main content

Mesenteric Trauma

  • Chapter
  • First Online:
The Mesenteric Organ in Health and Disease
  • 616 Accesses

Abstract

Mesenteric trauma represents a particular challenge as the diagnosis can be difficult based solely on clinical data and imaging. Laparoscopy has an increasing role in the diagnosis of mesenteric injuries, particularly in stable victims of anterior abdominal stab wounds. Surgical management centers around the extent of hemorrhage and bowel viability. The management of proximal mesenteric injuries is particularly challenging and is associated with significant morbidity and mortality. Much attention is currently being paid to further clinical diagnostic methods.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Suggested Reading

  1. Fullen WD, Hunt J, Altemeier WA. The clinical spectrum of penetrating injury to the superior mesenteric arterial circulation. J Trauma. 1972, Aug;12(8):656–64.

    Google Scholar 

  2. Frick EJ, Pasquale M, Cipolle M. Small bowel and mesentery injuries in blunt trauma. J Trauma. 1999;46(5):920–6.

    Article  Google Scholar 

  3. Fakhry SM, Brownstein M, Watts DD, Baker CC, Oller D. 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. 2000;48:408–15.

    Article  CAS  Google Scholar 

  4. Asensio JA, Britt LD, Borzotta A, Peitzman A, Miller FB, Mackersie RC, Pasquale MD, Pachter HL, Hoyt DB, Rodriguez JL, Falcone R, Davis K, Anderson JT, Ali J, Chand L. Multiinstitutional experience with the management of superior mesenteric, artery injuries. J Am Coll Surg. 2001;193(4):354–66.

    Article  CAS  Google Scholar 

  5. Fakhry SM, Watts DD, Luchette FA. Current diagnostic approaches lack sensitivity in the diagnosis of perforated blunt small injury: analysis from 275,557 trauma admissions from the east multi-institutional HVI trial. J Trauma. 2003;54:295–306.

    Article  Google Scholar 

  6. Asensio JA, Petrone P, Garcia-Nuñez L, Healy M, Martin M, Kuncir E. Superior mesenteric venous injuries: to ligate or to repair remains the question. J Trauma. 2007;62(3):668–75.

    PubMed  Google Scholar 

  7. Joseph DK, Kunac A, Kinler RL, Staff I, Butler KL. Diagnosing blunt hollow viscus injury: is computed tomography the answer? Am J Surg. 2013;205:414–8.

    Article  Google Scholar 

  8. Jones EL, Stovall RT, Jones TS, BEnsard DD, Burlew CC, Johnsons JL, Jurkovich GJ, Barnett CC, Peracci FM, Biffl WL, Moore EE. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg. 2014 April;76(4):1020–3.

    Google Scholar 

  9. McNutt MK, Chinapuvvula NR, Beckmann NM, Camp EA, Pommerening MJ, Laney RW, West OC, Gill BS, Kozar RA, Cotton BA, Wade CE, Adams PR, Holcomb JB. Early surgical intervention for blunt bowel injury: the bowel injury prediction score (BIPS). J Trauma Acute Care Surg. 2015;78(1):105–11.

    Article  Google Scholar 

  10. Lin HF, Chen YD, Lin KL, Wu MC, Wu CY, Chen SC. Laparoscopy decreases the laparotomy rate for hemodynamically stable patients with blunt hollow viscus and mesenteric injuries. Am J Surg. 2015;210:326–33.

    Article  Google Scholar 

  11. Bennett AE, Levenson RB, Dorfman JD. Multidetector CT imaging of bowel and mesenteric injury: review of key signs. Semin Ultrasound CT MRI. 2018;39:363–73.

    Article  Google Scholar 

  12. Bekker W, Hernandez MC, Zielinski MD, Kong VY, Laing GL, Bruce JL, Manchev V, Smith MTD, Clarke DL. Defining an intra-operative blunt mesenteric injury grading system and its use as a tool for surgical-decision making. Injury, Int J Care Injured. 2019;50(2019):27–32.

    Google Scholar 

  13. American Association for the Surgery of Trauma (AAST). Injury Scoring Scales. Available at: https://www.aast.org/Library/TraumaTools/InjuryScoringScales.aspx.

  14. Fakhry SM, Allawi A, Ferguson PL, Michetti CP, Newcomb AB, Liu C, Brownstein MR. Blunt small bowel perforation (SBP): an eastern association for the surgery of trauma multicenter update 15 years later. J Trauma. 2019;86(4):642–50.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph V. Sakran .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wong, E.G., Sakran, J.V. (2021). Mesenteric Trauma. In: Ehrenpreis, E.D., Alverdy, J.C., Wexner, S.D. (eds) The Mesenteric Organ in Health and Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-71963-0_45

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71963-0_45

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71962-3

  • Online ISBN: 978-3-030-71963-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics