SMALL-BOWEL PERFORATION FOLLOWING BLUNT ABDOMINAL-TRAUMA

Small bowel perforation is a relative infrequent complication of blunt abdominal trauma. We reviewed the literature regarding this clinical entity and describe our experience in 22 patients. There were 17 male and 5 female patients; mean age was 34 years. Cause of the trauma was road traffic accident (18 cases) or fall (4 patients). Clinical invest igation, peritoneal lavage, CT scanning, upper G1 tract opacification and subsequent laparotomy revealed a lesion of the duodenum in 3 cases , of the jejunum in 15 cases and of the ileum in 4 cases. Therapy cons isted in primary closure of the bowel (17 cases); tube drainage in 4 c ases and anus praeter in 1 case. One patient died because of ARDS and inflammatory syndrome; all the other patients had an uneventful postop erative course. It is concluded that peritoneal lavage remains the mos t appropriate diagnostic approach. In the absence of peritonitis prima ry closure can be safely done; otherwise tube drainage or anus praeter construction should be performed.