Evaluation of serum biomarkers and clinico-radiological correlation to improve the diagnosis of bowel and mesenteric injury following blunt abdominal trauma

The management of blunt bowel and mesenteric injury (BBMI) is one of the difficult challenges in the trauma field. The reported incidence of BBMIs among abdominal trauma patients is around 1–3 % and leads to morbidity and mortality in trauma patients. The present study was done to assess the early diagnostic accuracy of these serum biomarkers to predict bowel/mesenteric injuries in conjunction with CT scan. A total 50 patients were included and divided into two groups in the study, 25 Patients with isolated blunt abdominal trauma and 25 patients without any evidence of abdominal trauma viz. - isolated chest trauma or orthopedic trauma or traumatic brain injury. Serum samples of all patients were taken at 4 occasions. Laboratory and radiographic evaluation was done. For statistical analysis, Statistical Package for the Social Sciences (SPSS), Version 23.0. IBM Corp., NY) was used. In our study, majority of patients were male with male: female ratio was 9 : 1. We found that road traffic accident is the main cause of injury (33/50) followed by fall from height (7/50). Both the groups were equally distributed according to mechanism of injury (p = 0.522). Patients were assessed according to serological parameters at follow up. ROC analysis was performed for different serological markers suggesting high sensitivity and specificity for I-FABP and Citrulline to diagnose intestinal injury. The result of the study revealed that serological marker and radiological determinants were valuable adjunct with serological markers to determine the presence of mesenteric injury and plan of management.