Mesenteric tear

Case contributed by Dr Jeremy Jones

Presentation

Restrained rear-seat passenger in car accident.

Patient Data

Age: 7 years
Gender: Male
X-ray

Underinspired film, but bilateral patchy airspace opacification. Normal pelvis.

CT

Dense mesenteric blush at the mesenteric root with contrast pooling in the left-posterior peritoneal cavity. Superior mesenteric artery injury.

Small bowel ischaemia with bowel-wall thickening.

Bilateral pulmonary contusions.

Neck asymmetry with high-density foreign body posteriorly.

CT

Source 1 mm slices from original CT

Thin slices through the upper abdomen.

Superior mesenteric artery injury with attenuation of the artery and high density blush within the meseneric root. Contrast pooling in the left posterior abdomen.

Case Discussion

Mesenteric root injuries are not-uncommonly seen in lap-belt injuries where there is forced hyperflexion abdominal injury. These may be associated with vascular injury which may be arterial or venous. 

In this case, the high density of the contrast within the mesenteric root and peritoneal cavity helps to confidently identify this as arterial extravasation.

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Case information

rID: 45822
Case created: 9th Jun 2016
Last edited: 31st Jul 2017
Inclusion in quiz mode: Included

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