Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury.
Shem K BlackleyWilliam C SmithYann-Leei LeeChristopher KinnardAshley Y WilliamsCharles C ButtsMaryann I MbakaAndrew HaiflichAndrew BrightJon D SimmonsNathan M PolitePublished in: The American surgeon (2023)
In total, 30 patients had surgically confirmed BBMI. Active extravasation, pneumoperitoneum, hemoperitoneum without SOI, mesenteric stranding, and peritonitis were significant indicators of BBMI requiring intervention. CT and clinical findings cannot reliably predict the need for surgical intervention without ≥1 of these findings. Initial nonoperative management with serial clinical exams should be strongly considered to reduce incidence of nontherapeutic laparotomies.