Blunt Injury of the Bowel and Mesentery

  • Matthew Dattwyler
  • Uttam K. Bodanapally
  • Kathirkamanathan Shanmuganathan
Emergency Radiology (J Yu, Section Editor)
Part of the following topical collections:
  1. Emergency Radiology


Purpose of Review

Although not common, blunt bowel and mesenteric trauma requires prompt identification and intervention to avoid significant morbidity and mortality.

Recent Findings

Developments in MDCT technology especially with 64 and higher slice MDCT have improved image quality for better detection and depiction of bowel and mesenteric injury. Recent reports indicate that administration of oral contrast does not increase diagnostic accuracy, allowing for more rapid door to scan time. Dual-source CT (DS-CT) ability to generate iodine maps and virtual noncontrast images has the potential to increase conspicuity of bowel perfusion abnormalities, better distinguish hypo-perfused from nonperfused bowel, and reveal bowel wall hematoma obscured by mural enhancement.


This article will review the current state-of-the-art approach in using direct and indirect MDCT signs of bowel injury in an attempt to differentiate surgical from nonsurgical lesions, and discuss imaging protocols used at our institution for follow-up imaging in nonsurgical lesions. We will also demonstrate the potential utility of DS-CT in blunt bowel injury.


Bowel injury Emergency radiology MDCT DS-CT Mesenteric trauma 



Uttam K. Bodanapally reports personal fees from Siemens Medial Solutions.

Compliance with Ethical Standards

Conflict of interest

Matthew Dattwyler and Kathirkamanathan Shanmuganathan each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Matthew Dattwyler
    • 1
  • Uttam K. Bodanapally
    • 1
  • Kathirkamanathan Shanmuganathan
    • 1
    • 2
  1. 1.Department of Diagnostic Radiology and Nuclear Medicine, R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of RadiologyUniversity of Maryland Medical CenterBaltimoreUSA

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