@article{ref1,
title="Occult bowel injury after blunt abdominal trauma",
journal="American journal of surgery",
year="2019",
author="Loftus, Tyler J. and Morrow, Megan L. and Lottenberg, Lawrence and Rosenthal, Martin D. and Croft, Chasen A. and Smith, R. Stephen and Moore, Frederick A. and Brakenridge, Scott C. and Borrego, Robert and Efron, Philip A. and Mohr, Alicia M.",
volume="218",
number="2",
pages="266-270",
abstract="BACKGROUND: Following blunt abdominal trauma, bowel injuries are often missed on admission computed tomography (CT) scan. <br><br>METHODS: Multicenter retrospective analysis of 176 adults with moderate-critical blunt abdominal trauma and admission CT scan who underwent operative exploration. Patients with a bowel injury missed on CT (n = 36, 20%) were compared to all other patients (n = 140, 80%). <br><br>RESULTS: The missed injury group had greater incidence free fluid without solid organ injury on CT scan (44% vs. 25%, p = 0.038) and visceral adhesions (28% vs. 6%, p = 0.001). Independent predictors of missed bowel injury included prior abdominal inflammation (OR 3.74, 95% CI 1.37-10.18), CT evidence of free fluid in the absence of solid organ injury (OR 2.31, 95% CI 1.03-5.19) and intraoperative identification of visceral adhesions (OR 4.46, 95% CI 1.52-13.13). <br><br>CONCLUSIONS: Patients with visceral adhesive disease and indirect evidence of bowel injury on CT scan were more likely to have occult bowel injury.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2018.11.018",
url="http://dx.doi.org/10.1016/j.amjsurg.2018.11.018"
}