Gastrointestinal tract perforation following blunt abdominal trauma: an institution’s experience

Abstract

Prompt and early surgery for traumatic gastrointestinal perforation is advised. Any abnormal CT scans warrants either surgery or close monitoring. Direct repair of the perforation is preferred, if possible.

Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Touré

“…The average age of 25 years of our patients is young and can be superimposed on that of the literature [4] [5] [6] [7] [8]. The young age of our patients is explained by the fact that they account for 55.2% of the population, according to the latest demographic survey EDS 2012.…”

Nonsurgical management of traumatic pneumoperitoneum in a cat

“…In one study, a delay in surgical intervention of as little as 5 h significantly increased mortality while delays of 8 h or more resulted in mortality directly attributable to the bowel injury in another report . Conversely, other studies do not demonstrate a significant effect of delay on prognosis . Mandatory laparotomy reduces the chance of a missed injury but negative laparotomy is not without risk.…”

“…Diagnostic peritoneal lavage appears to be a very sensitive test but has low specificity, particularly in the presence of hemorrhage; specificity can be improved by calculation of a cell count ratio to account for this . A major disadvantage of performing diagnostic peritoneal lavage is that introduction of air and/or fluid complicates interpretation of subsequent abdominal imaging . Instead, serial abdominal ultrasound was performed to assess for changes in the volume of fluid or air and any changes in the degree of pancreatic/mesenteric inflammation or gastrointestinal motility, which would raise concern for development of peritonitis.…”

“…26,27 A major disadvantage of performing diagnostic peritoneal lavage is that introduction of air and/or fluid complicates interpretation of subsequent abdominal imaging. 28,29 Instead, serial abdominal ultrasound was performed to assess for changes in the volume of fluid or air and any changes in the degree of pancreatic/mesenteric inflammation or gastrointestinal motility, which would raise concern for development of peritonitis.…”

“…37 Conversely, other studies do not demonstrate a significant effect of delay on prognosis. 28,38,39 Mandatory laparotomy reduces the chance of a missed injury but negative laparotomy is not without risk. Potential complications in people include pulmonary complications, splenic injury, bowel obstruction, prolonged ileus, urinary tract infection, herniation, and wound infection with a reported short-term complication rate of 45% in one study.…”