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Small bowel stricture following blunt abdominal trauma
Shailendra Lalwani1, Manoj Gupta, Vibha Varma
1Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi - 110060, India. slalwani2008@yahoo.com
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|June 16, 2012
Summary
Late small bowel strictures after blunt abdominal trauma are rare but can cause obstruction. Diagnosis requires considering a history of trauma, even with subtle symptoms, for timely surgical intervention.
Area of Science:
- Surgical Gastroenterology
- Trauma Surgery
- Abdominal Imaging
Background:
- Late presentation of small bowel strictures post-blunt abdominal trauma is uncommon.
- Conservative management of blunt abdominal trauma can mask subtle intestinal injuries.
Purpose of the Study:
- To investigate the occurrence and characteristics of late small bowel obstruction following blunt abdominal trauma.
- To highlight the diagnostic challenges and management of these rare cases.
Main Methods:
- Retrospective review of prospectively maintained surgical records over 12 years.
- Inclusion of 8 patients with small bowel obstruction after initial conservative management of blunt abdominal trauma.
Main Results:
- A cohort of 7 males and 1 female (mean age 37) presented with small bowel obstruction.
- Common symptoms included abdominal pain, vomiting, and distension; solitary strictures were most frequent in the terminal ileum.
- Diagnosis was confirmed via barium meal studies and CT scans, with curative laparotomy and bowel resection; no mortality was observed.
Conclusions:
- Post-traumatic small bowel obstruction should be considered in patients with a history of blunt abdominal trauma presenting with abdominal pain, even without distension or vomiting.
- Early consideration in differential diagnosis can lead to timely intervention and improved patient outcomes.
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