Predictive Value of Preoperative CT Findings for Bowel Ischemia in Patients with Blunt Mesenteric Injury: A Retrospective Cohort Study
Abstract
1. Introduction
2. Methods
2.1. Patients and Study Design
2.2. Definition of CT Findings
2.3. Indications for Emergency Operation
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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| Variable | Overall (n = 174) | Ischemia (n = 30) | Non-Ischemia (n = 144) | p-Value |
|---|---|---|---|---|
| Age (years) | 53.70 ± 15.57 | 52.47 ± 14.26 | 53.96 ± 15.87 | 0.634 |
| Male sex (%) | 79.3% | 86.7% | 77.8% | 0.331 |
| ISS | 13.78 ± 8.75 | 18.50 ± 9.22 | 12.80 ± 8.35 | 0.001 * |
| Shock Index † | 0.82 ± 0.28 | 0.84 ± 0.38 | 0.82 ± 0.26 | 0.675 |
| RBC transfusion for 24 h (units) | 2.36 ± 3.15 | 3.00 ± 3.10 | 2.22 ± 3.16 | 0.220 |
| Cause of trauma | ||||
| In-car TA | 73 | 16 | 57 | 0.222 |
| Motorcycle TA | 27 | 5 | 22 | 0.787 |
| Pedestrian | 20 | 0 | 20 | 0.027 * |
| Crush injury | 32 | 8 | 24 | 0.203 |
| Fall | 12 | 0 | 12 | 0.225 |
| Slip down | 5 | 0 | 5 | 0.589 |
| Bicycle | 5 | 1 | 4 | 1.000 |
| CT Finding | Ischemia (n = 30), n (%) | Non-Ischemia (n = 144), n (%) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | OR (95% CI) | p-Value |
|---|---|---|---|---|---|---|---|---|
| Decreased bowel wall enhancement | 8 (26.7) | 0 (0.0) | 26.7 | 100.0 | 100.0 | 86.7 | 109.18 (6.09–1957.81) | <0.001 * |
| Extravasation type 1 (Free intraperitoneal) | 1 (3.3) | 19 (13.2) | 3.3 | 86.8 | 5.0 | 81.2 | 0.33 (0.06–1.81) | 0.205 |
| Extravasation type 2 (Contrast tracking bowel contour) | 7 (23.3) | 4 (2.8) | 23.3 | 97.2 | 63.6 | 85.9 | 9.96 (2.86–34.70) | <0.001 * |
| Dependent portion fluid | 21 (70.0) | 67 (46.5) | 70.0 | 53.5 | 23.9 | 89.5 | 2.60 (1.13–5.96) | 0.026 |
| Mesenteric haziness | 5 (16.7) | 66 (45.8) | 16.7 | 54.2 | 7.0 | 75.7 | 0.25 (0.10–0.68) | 0.004 |
| Mesenteric hematoma | 3 (10.0) | 54 (37.5) | 10.0 | 62.5 | 5.3 | 76.9 | 0.21 (0.07–0.68) | 0.003 |
| Pseudoaneurysm | 10 (33.3) | 61 (42.4) | 33.3 | 57.6 | 14.1 | 80.6 | 0.70 (0.31–1.57) | 0.418 |
| Interloop fluid | 10 (33.3) | 39 (27.1) | 33.3 | 72.9 | 20.4 | 84.0 | 1.37 (0.60–3.13) | 0.508 |
| CT Finding | aOR (95% CI) | p-Value |
|---|---|---|
| Decreased bowel wall enhancement | 5.45 (2.62–9.37) | <0.001 * |
| Extravasation type 1 (free intraperitoneal) | 0.55 (0.32–1.01) | 0.067 |
| Extravasation type 2 (contrast tracking bowel contour) | 3.07 (1.51–5.73) | <0.001 * |
| Dependent portion fluid | 1.08 (0.70–1.91) | 0.767 |
| Mesenteric haziness | 0.32 (0.19–0.57) | <0.001 * |
| Mesenteric hematoma | 0.34 (0.20–0.53) | <0.001 * |
| Pseudoaneurysm | 1.02 (0.55–1.90) | 0.950 |
| Interloop fluid | 1.29 (0.68–2.06) | 0.383 |
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Hwang, S.; Cho, S.H.; Jung, C.-Y.; Lim, K.H.; Kim, G.W. Predictive Value of Preoperative CT Findings for Bowel Ischemia in Patients with Blunt Mesenteric Injury: A Retrospective Cohort Study. J. Clin. Med. 2026, 15, 1330. https://doi.org/10.3390/jcm15041330
Hwang S, Cho SH, Jung C-Y, Lim KH, Kim GW. Predictive Value of Preoperative CT Findings for Bowel Ischemia in Patients with Blunt Mesenteric Injury: A Retrospective Cohort Study. Journal of Clinical Medicine. 2026; 15(4):1330. https://doi.org/10.3390/jcm15041330
Chicago/Turabian StyleHwang, Suyeong, Sung Hoon Cho, Chang-Yeon Jung, Kyoung Hoon Lim, and Gun Woo Kim. 2026. "Predictive Value of Preoperative CT Findings for Bowel Ischemia in Patients with Blunt Mesenteric Injury: A Retrospective Cohort Study" Journal of Clinical Medicine 15, no. 4: 1330. https://doi.org/10.3390/jcm15041330
APA StyleHwang, S., Cho, S. H., Jung, C.-Y., Lim, K. H., & Kim, G. W. (2026). Predictive Value of Preoperative CT Findings for Bowel Ischemia in Patients with Blunt Mesenteric Injury: A Retrospective Cohort Study. Journal of Clinical Medicine, 15(4), 1330. https://doi.org/10.3390/jcm15041330

