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Small bowel perforation following blunt abdominal trauma
W Ceelen1, U Hesse, B De Hemptinne
1Surgery Department, University of Gent, Belgium.
Acta Chirurgica Belgica
|January 1, 1995
Summary
Blunt abdominal trauma can cause small bowel perforation. Peritoneal lavage is the best diagnostic method, with primary closure being safe if peritonitis is absent.
Area of Science:
- Trauma Surgery
- Gastrointestinal Surgery
- Emergency Medicine
Background:
- Small bowel perforation is a rare but serious complication of blunt abdominal trauma.
- Prompt diagnosis and management are crucial for patient outcomes.
Purpose of the Study:
- To review the literature on small bowel perforation secondary to blunt abdominal trauma.
- To present the authors' experience with 22 such patients.
- To evaluate diagnostic and therapeutic strategies.
Main Methods:
- Literature review.
- Retrospective analysis of 22 patients with blunt abdominal trauma and small bowel perforation.
- Diagnostic methods included clinical examination, peritoneal lavage, CT scanning, and upper GI tract opacification.
- Surgical intervention (laparotomy) was performed in all cases.
Main Results:
- Road traffic accidents were the most common cause (18/22).
- Perforations occurred in the duodenum (3), jejunum (15), and ileum (4).
- Primary bowel closure was successful in 17 patients; tube drainage or anus praeter was used in 5.
- One patient died from ARDS and inflammatory syndrome; others had good outcomes.
Conclusions:
- Peritoneal lavage is the most appropriate diagnostic approach for suspected small bowel perforation after blunt abdominal trauma.
- Primary closure of the bowel is a safe option when peritonitis is absent.
- Tube drainage or anus praeter construction is indicated in cases with peritonitis.