A Kordzadeh1, V Melchionda2, K M Rhodes3, E O Fletcher2, Y P Panayiotopolous2. 1. Mid Essex Hospital Services NHS Trust, Department of General and Vascular Surgery, Broomfield Hospital, Court Road, Essex, CM1 7ET, UK. alikordzadeh@gmail.com. 2. Mid Essex Hospital Services NHS Trust, Department of General and Vascular Surgery, Broomfield Hospital, Court Road, Essex, CM1 7ET, UK. 3. Department of Accident and Emergency, Southend University Hospital NHS Foundation Trust, Westcliff-on-sea, Essex, SS0 0RY, UK.
Abstract
PURPOSE: The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on their overall management. MATERIALS AND METHODS: A systematic review of literature in MedLine, Embase, Scopus and CINHAL in English language from 1951 to November 2014 was performed. A total of 20 reported cases were identified. Variables including patient's demographics, signs and symptoms, mechanism of injury, investigative modality, management, length of stay, follow-up and outcomes were reviewed and analyzed. RESULTS: The median age of the cohort was 28.5 years (range 10-58 years), with a male-to-female ratio of 3:1. The commonest mechanism of injury was road traffic accident due to seat belt restraint (n = 12, 60 %). The commonest presentation was diffuse abdominal tenderness (n = 10, 45 %) followed by ecchymosis/bruising (n = 9, 40 %). Computed tomography (CT) remained the investigative modality of choice (n = 9, 45 %). All cases had an emergency exploratory laparotomy (n = 18, 90 %) within the initial 24 h and the median length of stay was 19 days (range 4-90 days). The overall mortality was 15 % (n = 3). CONCLUSION: Mesenteric avulsion is rare and has a complex and vague presentation. Due to its potential mortality and morbidity, emergency physicians should keep a high index of suspicion in individuals with blunt abdominal trauma from any mechanism of injury.
PURPOSE: The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on their overall management. MATERIALS AND METHODS: A systematic review of literature in MedLine, Embase, Scopus and CINHAL in English language from 1951 to November 2014 was performed. A total of 20 reported cases were identified. Variables including patient's demographics, signs and symptoms, mechanism of injury, investigative modality, management, length of stay, follow-up and outcomes were reviewed and analyzed. RESULTS: The median age of the cohort was 28.5 years (range 10-58 years), with a male-to-female ratio of 3:1. The commonest mechanism of injury was road traffic accident due to seat belt restraint (n = 12, 60 %). The commonest presentation was diffuse abdominal tenderness (n = 10, 45 %) followed by ecchymosis/bruising (n = 9, 40 %). Computed tomography (CT) remained the investigative modality of choice (n = 9, 45 %). All cases had an emergency exploratory laparotomy (n = 18, 90 %) within the initial 24 h and the median length of stay was 19 days (range 4-90 days). The overall mortality was 15 % (n = 3). CONCLUSION: Mesenteric avulsion is rare and has a complex and vague presentation. Due to its potential mortality and morbidity, emergency physicians should keep a high index of suspicion in individuals with blunt abdominal trauma from any mechanism of injury.
Authors: Fernando A C Spencer Netto; Paul Hamilton; Sandro B Rizoli; Bartolomeu Nascimento; Frederick D Brenneman; Homer Tien; Lorraine N Tremblay Journal: J Trauma Date: 2006-11
Authors: I Sall; H El Kaoui; S M Bouchentouf; A Ait Ali; A Bounaim; A Hajjouji; H Baba; M Fahssi; A Alhyane; A Zentar; K Sair Journal: Hernia Date: 2009-01-20 Impact factor: 4.739