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Mon Dec 22 22:29:09 GMT 2008

Given the CT findings of mesenteric bleeding AND bowel wall thickening, I would go to the OR - you are going to have to rule out ischemic injury to the bowel, and better do that earlier, especially in someone with obesity as a co-"morbidity" (sorry - couldn't resist).

Ron

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
Sent: Saturday, December 20, 2008 9:30 PM
To: Trauma Trauma
Subject: Stable pt w mesenteric extrav

Another case we saw 2 days ago:

67M post-MVA single rollover, brought to us about 5-6hrs post-accident. BMI>30. Stable vitals, GCS=14-15. CT abdo showed segmental SB and splenic flexure thickening with active but completely contained in the LUQ extrav from the mesenetery. Very small amount of FF in the pelvis, no other injuries, no FA.
Anyone have experience with embolization of mesenteric branches after checking for collaterals during angio? Or would u take him to OR solely based on CT findings even if the hematoma/extrav was very small and contained?

K

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Stable pt w mesenteric extrav