Document Type : Letter to Editor

Authors

1 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhli, India

2 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences,New Dehli, India

3 Division of Trauma Surgery and Critical Care,JPN Apex Trauma Center, All India Institute of Medical Sciences,New Dehli ,India

4 Division of Trauma Surgery and Critical Care,JPN Apex Trauma Center, All India Institute of Medical Sciences, New Dehli ,India

5 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Dehli, India

6 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Dehhi , India

Abstract

Colonic injuries after blunt trauma abdomen are a rare entity which may sometimes have a delayed presentation
. In the intensive care unit (ICU), various interventions like sedation, analgesia and paralysis may confound
clinical examination findings pertaining to abdominal pathology. Computed tomography (CT) provides an
excellent diagnostic modality in blunt trauma abdomen but requirement of high ventilatory support and/or
vasopressors may preclude safe transfer of patients from ICU to radiology suites. Point of care ultrasound (POCUS)
provides an excellent adjunct in diagnosis of hollow viscus perforation and is considered as a reliable alternative to
plain radiograph for the diagnosis of pneumoperitoneum

Keywords

Main Subjects

1. Ertugrul G, Coskun M, Sevinc M, Ertugrul F, Toydemir T.Delayed presentation of a sigmoid colon injury following
blunt abdominal trauma: a case report. J Med Case Rep. 2012;6: 247.
2. Faria GR, Almeida AB, Moreira H, Barbosa E, Correia-da-SilvaP, Costa-Maia J, et al. Prognostic factors for traumatic bowel injuries: Killing time. World J Surg. 2012; 36: 807-12.
3. Iaselli F, Mazzei MA, Firetto C, D’Elia D, Squitieri NC,Biondetti PR et al. Bowel and mesenteric injuries from blunt
abdominal trauma: a review. Radiol Med. 2015; 120: 21-32.doi: 10.1007/s11547-014-0487-8.
4. Bielecki K, Kamiński P, Klukowski M. Large bowel perforation:morbidity and mortality. Tech Coloproctol. 2002; 6: 177-82.doi: 10.1007/s101510200039.
5. Jones R. Recognition of pneumoperitoneum using bedside ultrasound in critically ill patients presenting with acute
abdominal pain. Am J Emerg Med. 2007; 25: 838–41. doi:10.1016/j.ajem.2007.02.004.
6. Zhi HJ, Zhao J, Nie S, Ma YJ, Cui XY, Zhang M, et al.Prediction of acute kidney injury: the ratio of renal resistive
index to semiquantitative power Doppler ultrasound score-a better predictor?: A prospective observational study.
Medicine (Baltimore). 2019; 98(21): e15465. doi: 10.1097/MD.0000000000015465.
7. Khor M, Cutten J, Lim J, Weerakkody Y. Sonographic detection of pneumoperitoneum. BJR Case Rep. 2017; 3: 20160146.doi: 10.1259/Bjrcr.20160146
8. Raturi S, Chandran S, James TE, Rajadurai VS. Radiological signs of pneumoperitoneum in an extremely low birthweight infant. BMJ Case Rep. 2014; 2014: bcr2014205510. doi:10.1136/bcr-2014-205510.
9. Jiang L, Wu J, Feng X. The value of ultrasound in diagnosisof pneumoperitoneum in emergent or critical conditions: a
meta-analysis. Hong Kong J Emerg Med. 2018; 26: 111-7.doi:10.1177/1024907918805668.