- Uncommon injury in blunt trauma
- Severe direct force is usually required to produce this injury, mostly from motor vehicle collision
- Often associated with other injuries, both intra- (liver, spleen, small bowel mesentery) and extra-abdominal (skeletal, facial, neurologic)
- CT may not be 100% sensitive. Findings could be overlooked in multiply-injured patients, large patients or if metallic monitoring/support devices are obscuring the area.
- "Normal" CT could be misleading when other factors such as physical examination is not taken into account. Re-review of images to look for subtle free fluid/air is essential in these cases.
- Discontinuity of bowel wall
- Extraluminal contrast leakage
- Extraluminal air either intra- or retroperitoneal (nonspecific, can be seen after DPL, mechanical ventilation, barotrauma, etc)
- Intramural air
- Bowel wall thickening
- Bowel wall enhancement
- Mesenteric fat stranding
- Intraperitoneal and retroperitoneal fluid
- Barden BE et al. Perforation of the colon after blunt trauma. South Med J 2000;93(1)
- Brody JM, et al. CT of blunt trauma bowel and mesenteric injury: typical findings and pitfalls in diagnosis. RadioGraphics 2000;20: 1525