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Blunt abdominal trauma and mesenteric avulsion: a systematic review

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on their overall management.

Materials and methods

A systematic review of literature in MedLine, Embase, Scopus and CINHAL in English language from 1951 to November 2014 was performed. A total of 20 reported cases were identified. Variables including patient’s demographics, signs and symptoms, mechanism of injury, investigative modality, management, length of stay, follow-up and outcomes were reviewed and analyzed.

Results

The median age of the cohort was 28.5 years (range 10–58 years), with a male-to-female ratio of 3:1. The commonest mechanism of injury was road traffic accident due to seat belt restraint (n = 12, 60 %). The commonest presentation was diffuse abdominal tenderness (n = 10, 45 %) followed by ecchymosis/bruising (n = 9, 40 %). Computed tomography (CT) remained the investigative modality of choice (n = 9, 45 %). All cases had an emergency exploratory laparotomy (n = 18, 90 %) within the initial 24 h and the median length of stay was 19 days (range 4–90 days). The overall mortality was 15 % (n = 3).

Conclusion

Mesenteric avulsion is rare and has a complex and vague presentation. Due to its potential mortality and morbidity, emergency physicians should keep a high index of suspicion in individuals with blunt abdominal trauma from any mechanism of injury.

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Acknowledgments

No funding was received.

Conflict of interest

Ali Kordzadeh, Veronica Melchionda, Karen M.Rhodes, Edward O. Fletcher and Yiannis P. Panayiotopolous declare that they have no conflict of interest.

Ethical approval

Not applicable.

Human and animal studies

The study described in this article does not contain studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Mid Essex Hospital Services NHS Trust, Department of General and Vascular Surgery, Broomfield Hospital, Court Road, Essex, CM1 7ET, UK

    A. Kordzadeh, V. Melchionda, E. O. Fletcher & Y. P. Panayiotopolous

  2. Department of Accident and Emergency, Southend University Hospital NHS Foundation Trust, Westcliff-on-sea, Essex, SS0 0RY, UK

    K. M. Rhodes

Authors
  1. A. Kordzadeh
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  2. V. Melchionda
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  3. K. M. Rhodes
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  4. E. O. Fletcher
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  5. Y. P. Panayiotopolous
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Corresponding author

Correspondence to A. Kordzadeh.

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Kordzadeh, A., Melchionda, V., Rhodes, K.M. et al. Blunt abdominal trauma and mesenteric avulsion: a systematic review. Eur J Trauma Emerg Surg 42, 311–315 (2016). https://doi.org/10.1007/s00068-015-0514-z

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  • DOI: https://doi.org/10.1007/s00068-015-0514-z

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