[Secondary peritonitis after negative computerized tomography in blunt abdominal trauma]. 1994

J P Barras, and M Gilg, and B Regli, and W Schweizer
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital Bern.

Diagnostic peritoneal lavage has widely been replaced by emergency sonography in the evaluation of blunt abdominal trauma. CT is generally performed in cases without major hemodynamic instability in order to define non-operative treatment of injuries of the parenchymatous organs or to precise the extension of retroperitoneal, spinal and pelvic lesions. Despite the good results of this method for the mentioned indications, the low sensitivity of CT for lesions of hollow viscus should not be forgotten. We report 3 cases of lesions of the small bowel (2 perforations and 1 mesenteric lesion with ischemic bowel wall) which were not visible, even retrospectively, at the CT. Despite discrete clinical signs, these lesions were only diagnosed at the stage of obvious secondary peritonitis. These cases should remind us the limits of CT in the evaluation of abdominal visceral lesions in blunt trauma.

UI MeSH Term Description Entries
D007416 Intestinal Perforation Opening or penetration through the wall of the INTESTINES. Intestinal Perforations,Perforation, Intestinal,Perforations, Intestinal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009104 Multiple Trauma Multiple physical insults or injuries occurring simultaneously. Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D010538 Peritonitis INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs. Primary Peritonitis,Secondary Peritonitis,Peritonitis, Primary,Peritonitis, Secondary
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000007 Abdominal Injuries General or unspecified injuries involving organs in the abdominal cavity. Injuries, Abdominal,Abdominal Injury,Injury, Abdominal
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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