CT findings of bowel and mesenteric injury

Bowel and mesenteric injuries are common sequelae of blunt abdominal trauma. CT represents a valuable modality in the diagnosis of bowel and mesenteric injuries. While certain findings on CT are highly specific, such as free air and extravasation of oral contrast agent, they are insensitive and seen only in the minority of patients. Therefore, radiologists must focus their attention on the bowel wall and mesentery to improve their diagnostic accuracy in these injuries. Bowel wall thickening and/or abnormal bowel wall enhancement must be noted. Mesenteric abnormalities, which can consist of mesenteric infiltration, interloop fluid, or fluid trapped in the leaves of the small bowel mesentery, may be crucial yet subtle clues. Knowledge of their typical appearance may aid in their diagnosis. This pictorial essay illustrates the range of findings in bowel and mesenteric injuries as well as possible pitfalls to help in their prompt recognition and diagnosis.