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Bowel and Mesenteric Injury: Evaluation with Emergency Abdominal US1

John R. Richards, MD, John P. McGahan, MD, Jamie L. Simpson and Payam Tabar

1 From the Division of Emergency Medicine (J.R.R., J.L.S., P.T.) and the Department of Radiology (J.P.M.), University of California, Davis Medical Center, 2315 Stockton Blvd, Sacramento, CA 95817. From the 1998 RSNA scientific assembly. Received June 5, 1998; revision requested July 27; revision received August 24; accepted October 13. Address reprint requests to J.R.R.



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  		Figure 1a. Ascending colon laceration. (a) B = bladder, FL = fluid. Transverse US scan of the pelvis demonstrates a small amount of free fluid in the rectouterine pouch. (b) CT abdominal scan demonstrates thickening of the lower ascending colon (arrows). (c) CT scan of the pelvis demonstrates fluid in the rectouterine pouch (arrow), with loops of bowel anteriorly.

 


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  		Figure 1b. Ascending colon laceration. (a) B = bladder, FL = fluid. Transverse US scan of the pelvis demonstrates a small amount of free fluid in the rectouterine pouch. (b) CT abdominal scan demonstrates thickening of the lower ascending colon (arrows). (c) CT scan of the pelvis demonstrates fluid in the rectouterine pouch (arrow), with loops of bowel anteriorly.

 


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  		Figure 1c. Ascending colon laceration. (a) B = bladder, FL = fluid. Transverse US scan of the pelvis demonstrates a small amount of free fluid in the rectouterine pouch. (b) CT abdominal scan demonstrates thickening of the lower ascending colon (arrows). (c) CT scan of the pelvis demonstrates fluid in the rectouterine pouch (arrow), with loops of bowel anteriorly.

 


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  		Figure 2. H = liver, R = kidney. Mesenteric avulsion in the distal ileum. Longitudinal US scan demonstrates a small amount of free fluid in the hepatorenal fossa (arrow).

 


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  		Figure 3. Jejunal perforation and pneumoperitoneum. CT abdominal scan demonstrates free air just beneath the anterior abdominal wall (arrow).

 


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  		Figure 4. Jejunal perforation. CT abdominal scan demonstrates small-bowel wall thickening (arrows) in the left upper part of the abdomen.

 




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