Small bowel injuries : mechanism and outcome

Abstract EN

Background: Organ injury scale system is a new scale for anatomical classification of organ injury depending on the severity of injury we study this system with small bowel injury caused by blunt and penetrating trauma.

Patient and Methods: From September 1998 to September 2000, 64 cases with small intestinal trauma were hospitalized and underwent surgery in Al-Yarmouk Teaching Hospital.

Diagnosis was made on: A.

History B.

Physical exam C.

Peritoneal tap D.

Plain x-rays (when it is available).

Results: Small bowel injuries comprise about (30%) of blunt and penetrating abdominal trauma underwent la1arotomy.

There were 55 males and 9 females with mean age 26.6 years.

Penetrating injury accounted for 52 cases (81.25%) and blunt trauma was responsible in (12) cases (18.75%).

Using organ injury scale, penetrating wounds caused grade (III, IV) mainly (multiple perforations) while blunt trauma caused grade II mainly (single perforation).

There were 64 cases with jejunoileal injuries, most of them underwent resection and anastomosis.

Only one case developed enterocutaneous fistula (1.5%).

Shock was observed in (46.8%) of the cases and was related to the associated injuries but not to the grade of small intestinal injuries.

Mortality due to small bowel injuries occurred in (12.5%) and the incidences of abdominal complication was (25%).

The most common cause was wound infection (12.5%).

Peritoneal tap carried high false negative results (positive in 38.9%).