Blunt Isolated Small Bowel Perforation Intervention: Does a Delay in Management Matter?

Area of Science:

• Trauma Surgery
• Surgical Outcomes
• Abdominal Trauma

Background:

• Blunt small bowel injury presents diagnostic challenges.
• The impact of delayed surgical intervention on patient prognosis remains unclear.

Purpose of the Study:

• To investigate the effect of time to surgical intervention on outcomes in patients with blunt small bowel perforation.

Main Methods:

• Adult patients (>18 years) with blunt small bowel perforation undergoing computed tomography and surgery were analyzed.
• Patients were stratified into groups based on injury-to-surgery intervals: ≤8 hours, 8-24 hours, and >24 hours.
• Outcomes including length of stay (LOS), intensive care unit (ICU) LOS, morbidity, and mortality were assessed.

Main Results:

• No significant differences were observed in LOS, ICU LOS, morbidity, or mortality across the time-to-surgery groups.
• A significant difference was found in the rate of bowel resection, with higher rates in the >24-hour group.
• Analysis of two groups (≤24 hours vs. >24 hours) showed no significant difference in overall outcomes.

Conclusions:

• Delayed surgical intervention for blunt small bowel injuries does not appear to significantly affect length of stay, ICU length of stay, morbidity, or mortality.
• The primary outcome potentially affected by delayed intervention is the need for bowel resection.