Utility of Computed Tomography in Diagnosis of Small Bowel Perforation after Blunt Abdominal Trauma

ABSTRACT

BACKGROUNDS: The high mortality and morbidity rates associated with traumatic rupture of the hollow viscera have been attributed to the clinical difficulty in establishing an early diagnosis. The accuracy of CT in the detection of injuries of the solid visceral organ is well established, but the value of CT in diagnosing small bowel perforation artier blunt abdominal trauma is controversal. This study was conducted to ascertain CT findings of small bowel perforation result from blunt abdominal trauma. METHODS: A retrospective analysis of preoperative abdominal CT findings in 40 patients was performed. Small bowel perforation was confirmed by surgery. Precontrast and postcontrast enhanced CT images were obtained in all patients. RESULTS: Diagnostic findings of small bowel perforation including intraperitoneal or retroperitoneal free air, discontinuity of the bowel wall and extravasation of oral or IV contrast materials were observed in 34 cases(85%). The most common fading of small bowel perforation was intraperitoneal or retroperitoneal free fluid collection(90%), followed by segmental bowel wall thickening(83%), intraperitoneal or retroperitoneal free air(80%) and focal mesenteric fat infiltration(70%). CONCLUSIONS : The CT scan is sensitive and effective modality for evaluation of small bowel perforation after blunt abdominal truauma, because of high detectability of diagnostic antral suggestive CT findings.