図１４は省略．図１と図２のMorison窩と図１５と図１６の骨盤腔に腹水（※）を認め，図４〜図１２の空腸（J：臍を中心に右上から左下への斜線を境に空腸は左側に位置する傾向がある）は壁肥厚を示し，図４〜図１３で腸間膜に液貯留（↑：均一な低濃度）または血腫（↑：不均一なやや高濃度の部分）を認める．遊離ガスがあれば空腸穿孔の確定診断となるが，遊離ガスを認めなければ8時間以内に手術できるよう（下記文献），4，5時間後にCTの再検査をすべきである．2日も経って腹膜刺激症状が出現し手術となり，空腸穿孔が確認された（図A：白矢印）．

文献考察：鈍的外傷による小腸穿孔は受傷後8時間を過ぎると死亡率と術後合併症が急増する．
J Trauma. 2000 Mar;48(3):408-14; discussion 414-5.
Relatively short diagnostic delays (.
Fakhry SM, Brownstein M, Watts DD, Baker CC, Oller D.

OBJECTIVE: Blunt small bowel injury (SBI) is uncommon, and its timely diagnosis may be difficult. The impact of operative delays on morbidity and mortality has been unclear. The purpose of this study was to determine the relationship of diagnostic delays to morbidity and mortality in blunt SBI. METHODS: Patients with blunt SBI with perforation were identified from the registries of eight trauma centers (1989-1997). Patients with duodenal injuries were excluded. Data were extracted by individual chart review. Patients were classified as multi-trauma (group 1) or near-isolated SBI (group 2 with Abbreviated Injury Scale score