Blunt intestinal trauma. A modern-day review

Area of Science:

• Trauma Surgery
• Gastrointestinal Surgery
• Emergency Medicine

Background:

• Blunt abdominal trauma is a significant cause of morbidity and mortality.
• Motor vehicle accidents are the leading cause of blunt abdominal trauma, often resulting in multisystem injuries.
• Injuries to the small bowel, colon, and mesentery require prompt diagnosis and management.

Purpose of the Study:

• To analyze the characteristics and outcomes of patients with blunt abdominal trauma to the small bowel, colon, or mesentery.
• To evaluate the diagnostic accuracy of peritoneal lavage in identifying these injuries.
• To identify patterns and common locations of blunt bowel and mesenteric injuries.

Main Methods:

• Retrospective review of 196 patients treated for blunt trauma to the small bowel, colon, or mesentery.
• Data collection included injury mechanisms, injury types, diagnostic methods, and outcomes.
• Analysis of injuries diagnosed via peritoneal lavage and subsequent surgical findings.

Main Results:

• Over 80% of patients were victims of motor vehicle accidents, frequently presenting with multisystem injuries.
• Sixty patients sustained 83 major injuries (perforation or mesenteric injury with ischemic bowel), representing 6.9% of blunt trauma celiotomies.
• Peritoneal lavage diagnosed all but one injury; jejunal and ileal perforations were widespread, while colon injuries occurred mainly in the ascending and sigmoid regions.
• Only two duodenal injuries were identified.

Conclusions:

• Blunt small bowel, colon, and mesenteric injuries are serious complications of abdominal trauma, predominantly from motor vehicle accidents.
• Peritoneal lavage is a highly effective diagnostic tool for detecting these injuries.
• Understanding injury patterns aids in timely diagnosis and surgical planning for improved patient outcomes.