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Delayed intestinal perforation after nonpenetrating abdominal trauma
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|September 1, 1985
Summary
Seat-belt use correlates with increased hollow-organ injuries, often presenting with delayed intestinal perforation. Surgeons must consider this possibility in patients with persistent abdominal pain after trauma.
Area of Science:
- Trauma Surgery
- Abdominal Injury
- Seat-belt Restraints
Background:
- Hollow-organ injuries, particularly intestinal injuries, have seen a rise with seat-belt implementation.
- Clinical signs of intestinal injury can be significantly delayed, complicating diagnosis.
Purpose of the Study:
- To report cases of delayed intestinal perforation following nonpenetrating abdominal trauma.
- To highlight the diagnostic challenges posed by delayed perforations.
Main Methods:
- Retrospective case series of four patients.
- Analysis of motor vehicle accident cases involving passive seat-belt restraints.
- Review of clinical presentations and injury severity scores.
Main Results:
- Four patients experienced delayed intestinal perforation (≥6 days post-trauma).
- All patients had low initial injury severity scores (4-13) but persistent vague abdominal pain.
- Three patients sustained major spinal trauma concurrently.
Conclusions:
- Delayed intestinal perforation is a significant concern after blunt abdominal trauma with seat-belt use.
- Patients with persistent abdominal pain and low initial injury scores warrant careful monitoring for delayed perforation.
- Concurrent spinal trauma may increase the risk for delayed hollow-organ injury.