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Ischemic intestinal complications in patients with burns
M H Desai1, D N Herndon, R L Rutan
1Shriners Burns Institute, Galveston, Texas 77550.
Surgery, Gynecology & Obstetrics
|April 1, 1991
Summary
Trauma patients frequently experience intestinal damage and sepsis, with autopsy findings revealing significant ischemic intestinal pathology in over half of adult and child deaths. Endogenous bacteria were often the cause, highlighting a critical link between gut integrity and survival.
Area of Science:
- Medical research
- Gastroenterology
- Pathology
Background:
- Enteral bacterial translocation is a suspected cause of trauma-related illness.
- Clinical evidence of intestinal mucosal damage in trauma patients is limited.
Purpose of the Study:
- To investigate the incidence of intestinal pathological findings in trauma patients.
- To correlate intestinal pathology with sepsis and mortality.
Main Methods:
- Retrospective review of medical and autopsy records (1982-1988).
- Analysis of patient demographics, pathological findings, and clinical outcomes.
Main Results:
- 53% of adult and 61% of child deaths showed ischemic intestinal pathology.
- Over 80% of these patients were septic, with intestinal flora as the likely cause.
- Surgical intervention for intestinal pathology had a 69% mortality rate.
Conclusions:
- Significant intestinal pathology and sepsis are common in trauma mortality.
- Bacterial translocation from the gut may contribute to morbidity and mortality, especially in thermally injured patients.
- Clinical identification and surgical intervention for intestinal pathology show high mortality.