Traumatic seromuscular rupture of intestine: the acute and chronic forms

Traumatic seromuscular rupture of intestine in the acute form is recognized by surgeons and pathologists and has received mention in the medical literature. The authors encountered two cases of this lesion presenting in the chronic form, in one case initially going unrecognized, both in battered children. To our knowledge, the chronic form of the injury has not been previously described in the literature. Three lesions in the acute stage were used to analyze the evolutionary stages of the chronic presentation.

The two chronic cases are described, together with gross and microscopic photographs. Three acute lesions are also described, with illustrations, two in battered children and one in a pedestrian/vehicle fatality.

The three acute cases illustrate the pathogenesis and gradation of the injury that, in the absence of surgical therapy, will develop into the chronic lesion. The two chronic case descriptions illustrate the gross and microscopic pathology and the pathognomonic features.

Seromuscular rupture of the intestine, when left untreated, develops in time into a lesion that may appear cryptogenic to the surgeon or the pathologist. This paper defines that lesion and its pathogenesis.