Indications for Surgery in Patients with Mesenteric Injury Caused by Blunt Trauma, Including Those with Concomitant Intestinal Injury

Abstract

[Objective] This study was aimed at reviewing the indications for surgery in patients with mesenteric injury (MI) caused by blunt trauma, including those with concomitant intestinal injury, at our hospital. [Methods] For this retrospective study, we reviewed the medical records of patients with blunt trauma who had been found to have intramesenteric extravasation, intraperitoneal fluid collection, or increased mesenteric density on abdominal contrast-enhanced CT, suggestive of MI, at hospital arrival during the 15-year period from 2006. [Results] A total of 45 patients were identified. The acute care surgery group comprised 24 patients, including 13 patients who underwent combined surgery for mesenteric and intestinal injuries and 11 patients who underwent surgery for MI alone. The early conservative treatment group comprised 21 patients, including four patients who developed delayed intestinal injury. The percentage of patients with ≥ 2 CT findings suggestive of MI was significantly higher in those who underwent surgery for MI alone than in those who recovered with conservative treatment (P ＜ 0.01). [Conclusion] The presence of ≥ 2 CT findings upon hospital arrival was possibly a significant factor for determining the surgical indication for MI. Concomitant intestinal injury was observed in 54.2% of patients in the acute care surgery group.