Six Cases of Traumatic Injury of the Small Intestine Following Traffic Accidents

Abstract

Most small intestinal injuries are caused by blunt abdominal trauma during traffic accidents. Clinical presentation is often vague, and free air may not be detected early after injury. On the other hand, surgical delays can aggravate many cases. Here, we report six cases of traumatic small bowel perforation that were treated at our hospital over a 5-year period between 2000 and 2005. The time from presentation to surgery was less than 12 hours in four cases and longer than 12 hours in two cases. Computed tomography (CT) findings showed free air in the peritoneum in five cases, and all the cases exhibited intraperitoneal fluid at the time of the final diagnosis. The initial CT scan could not detect any signs of intestinal perforation in the two cases whose surgeries were delayed for more than 12 hours. These two patients were discharged after an eventful (What happened?) postoperative course, while the other patients were discharged without complications. Multiple CT examinations over time are the most appropriate means of investigating suspected small bowel perforation; changes in vital signs and physical examinations are also useful for diagnosing this condition.