ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2017, 2(4): 82–86
https://doi.org/10.26693/jmbs02.04.082
Clinical Medicine

Ultrasound Diagnosis of Intestine and Mesentery Damage with Blunt Abdominal Trauma

Lavrinenko A. S.
Abstract

Cases of more than 150 patients with closed abdominal trauma in the past 3 years, being on treatment in GU «Institute of general and urgent surgery the name of V.T. Zaycev NAMN Ukraine» were examined. Ultrasonic signs of damage and intestinal mesentery detected in 37 cases: gap mesentery bleeding (16), hematoma mesentery (8) and peritonitis due to injury of the small intestine (6), intestinal hematoma wall (7). The purpose of the article is to improve the diagnosis and intestinal damage mesentery with blunt abdominal trauma. Patients are divided into three groups: I group (17) – identification of signs of injury in the first hours after the trauma, II group (8) – detecting them during the first two days, III a group (12) – in the course of clinical observations. Diagnosis of intestinal damage and mesentery abdominal trauma with closed based on a set of ultrasonic signs – free fluid in the abdominal cavity, volume formation (hematoma) in the mesentery of the small intestine, local thickening of intestinal wall with a minimum amount of free liquid between loops of intestine, signs of peritonitis. Ultrasound is a screening, accessible method with informative 77.3%. Direct sign of intestinal trauma with closed abdominal trauma is local thickening of the intestinal wall of a layered structure with a minimum amount of free fluid in the abdominal cavity against the background of increasing dynamic intestinal obstruction. Ultrasound is a screening, accessible method with informative percentage – 77,3%. Hematoma of the small and large intestine erythema is characterized by the discovery of bulky formation of an inhomogeneous structure of middle and lower echogenicity, which is located in the erythemase and displaces the gut fragment. Free fluid in the abdominal cavity of an inhomogeneous nature with the content of small dense particles, thickening of the wall of the small intestine due to structures of elevated echogenicity, impaired motor and evacuation function of the gastrointestinal tract – indicate an injury of the cavitary organ with developing peritonitis.

Keywords: ultrasound, blunt abdominal trauma, intestinal damage and mesentery

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