TY  - JOUR
PY  - 2019//
TI  - Occult bowel injury after blunt abdominal trauma
JO  - American journal of surgery
A1  - Loftus, Tyler J.
A1  - Morrow, Megan L.
A1  - Lottenberg, Lawrence
A1  - Rosenthal, Martin D.
A1  - Croft, Chasen A.
A1  - Smith, R. Stephen
A1  - Moore, Frederick A.
A1  - Brakenridge, Scott C.
A1  - Borrego, Robert
A1  - Efron, Philip A.
A1  - Mohr, Alicia M.
SP  - 266
EP  - 270
VL  - 218
IS  - 2
N2  - 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>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2018.11.018
ID  - ref1
ER  -