Spectrum of CT Findings in Blunt Small-Bowel and Mesenteric Trauma: A Hospital-Based Study from a Tertiary Care Institute in South Kashmir

Background: Blunt small-bowel and mesenteric injuries are uncommon but potentially life-threatening. Computed tomography (CT) is the primary modality for evaluation; however, CT findings vary widely in sensitivity and specificity.
Objective: To describe the spectrum of CT findings in blunt small-bowel and mesenteric trauma at a tertiary care institute in South Kashmir and to correlate CT findings with same centre operative outcomes.

Methods: This retrospective observational study included 20 patients within a span of 12 months with blunt abdominal trauma who underwent contrast-enhanced multidetector CT (MDCT). CT signs were recorded using a structured checklist. CT overall impression was graded (Grade 1–4). Operative findings and clinical follow-up were used as the reference standard.

Results: The most frequent CT findings were free intraperitoneal fluid (70%), mesenteric fat stranding (65%), bowel wall thickening (50%), and mesenteric hematoma (30%). Direct signs were less frequent: free air (20%), bowel wall defect (15%), and active contrast extravasation (10%). Nine patients were classified as having surgically significant bowel/mesenteric injury. CT overall impression (Grade 3–4 positive) showed sensitivity 77.8% and specificity 90.9%. Direct signs showed very high specificity (100%) but low sensitivity.

Conclusion: In blunt small-bowel and mesenteric trauma, indirect CT signs such as free fluid and mesenteric stranding are common but less specific, while direct signs are highly specific though uncommon. Structured reporting and correlation with clinical status are essential to improve detection and timely management