[Blunt small intestinal trauma]

From 1986 to 1990, 41 patients with blunt small intestinal trauma were hospitalized and underwent surgery in Kuang Tien General Hospital. Included were 34 males and 7 females with a mean age of 37 years (range: 8 to 67). The mean duration of follow-up was 41 months. We classified the severity of small intestinal injury with the duodenum organ injury scale or small bowel organ injury scale published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A. A. S. T.) in 1990. According to the operative findings, the small intestinal injuries of the 41 cases were classified as follows: grade I-11 cases, grade II-16 cases, grade III-8 cases, grade IV-2 cases, and grade V-7 cases. Three cases had both duodenal and small bowel injuries. Among the patients, 4 cases were treated by drainage. Seven cases underwent simple repair. Three cases were treated with repair and drainage. Thirteen cases underwent enterorrhaphy and drainage. Seventeen cases were treated with resection and anastomosis. The mortality rate was 7.2%, whilst the morbidity rate was 34.0%. The most frequent postoperative complications related to the small intestinal injury in patients who survived the initial operation were wound infection (22.0%), intra-abdominal abscesses (4.8%), pulmonary infection (4.8%), and small bowel obstruction (2.4%).