Japanese Journal of Acute Care Surgery
Online ISSN : 2436-102X
Surgical indications for single traumatic mesenteric injury
Daisuke UenoYasukazu ShiinoTakahiro OkaneYuki InayoshiSachiko YamadaJiro TakahashiKimihisa KinoshitaSatomi MiyamotoTakahiro Inoue
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2021 Volume 10 Issue 1 Pages 73-78

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Abstract

Background:Mesenteric injury with intestinal injury is relatively easy to diagnose and treat. However, the treatment policy(including surgery and interventional radiology)for single traumatic mesenteric injury(STMI)is controversial. Materials and methods:The medical records of 66 patients with mesenteric injury who were admitted to our hospital between January 2008 and December 2019 were retrospectively reviewed. A total of 31 cases were examined, patients with other intraperitoneal organ complications, including intestinal tract complications, were excluded. Results:In patients with STMI, ascites on computed tomography(CT)and positive peritoneal irritation sign were not related to laparotomy. The positive of shock vital, extravasation, and focused assessment with sonography for trauma were relevant to laparotomy. Laparotomy was performed on all patients with mesenteric injury of traumatic classification(according to the Japanese Association for the Surgery of Trauma Organ Injury Classification 2008(JAST-OIC 2008))Ⅱb and two patients with mesenteric injury of JAST-OIC 2008Ⅱa on preoperative contrast-enhanced CT findings. Conclusion:For STMI, all patients with preoperative diagnosis of mesenteric injury of JAST-OIC 2008Ⅰa could undergo NOM, while all patients with preoperative diagnosis of mesenteric injury of JAST-OIC 2008Ⅱb underwent laparotomy. Some patients with preoperative diagnosis of mesenteric injury of JAST-OIC 2008Ⅱa required laparotomy, so surgery should be considered, or the patient should be observed in an environment where emergency surgery can be performed.

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© 2021 The Japanese Society for the Acute Care Surgery
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