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1. Bowel injury due to blunt trauma

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Figure 40-1

Bowel injury due to blunt trauma.

This 15-year-old patient suffered a lap belt injury during a motor vehicle crash. A. There is a large amount of free intraperitoneal fluid (arrow) in the pelvis. B. A CT image in the midportion of the abdomen shows dilated loops of jejunum. Mural hemorrhage and edema result in wall thickening of 1 of the loops of bowel (arrow) adjacent to the spine. C. A small amount of intraperitoneal air is present adjacent to the liver (arrow). Surgical exploration demonstrated a jejunal rupture.

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2. Duodenal hematoma

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Figure 40-2

Duodenal hematoma.

An upper GI image shows impression on the duodenal contrast column (arrow) by a mural hematoma.

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3. Duodenal hematoma

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Figure 40-3

Duodenal hematoma.

A large mural hematoma (arrow) causes anterior and rightward displacement of the enhancing mucosal layer of the duodenum on this axial CT image. There are 2 small air bubbles in the compressed duodenal lumen. Free intraperitoneal fluid is visible adjacent to the liver.

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4. Duodenal hematoma

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Figure 40-4

Duodenal hematoma.

CT of a 7-year-old child who had suffered blunt abdominal trauma shows a hematoma as a round nonenhancing focus along the posterior wall of the duodenum, anterior to the aorta and vena cava. There is also a small amount of free intraperitoneal fluid adjacent to the inferior margin of the liver.

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5. Pneumoperitoneum

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Figure 40-5

Pneumoperitoneum.

An upright radiograph of an infant with massive free intraperitoneal air due to gastric rupture shows gas outlining the inner and outer walls of a loop of bowel in the central portion of the abdomen (large arrows). Gas also outlines the falciform ligament (small arrow).

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6. Ingested foreign body

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Figure 40-6

Ingested foreign body.

An abdominal radiograph of a 4-year-old boy shows an ingested rock in the stomach.

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