Clinical features and treatment problems of intestinal and mesenteric injuries due to blunt abdominal trauma

Abstract

We studied 30 cases of intestinal and mesenteric injury due to blunt abdominal trauma experienced in our department over the past 12 years and 6 months, with the aim of clarifying the clinical features and treatment problems. Traffic accidents accounted for 24 cases （80％）, and seatbelt wearing cases accounted for 22 cases. Five of 14 cases of intestinal injury （36％） had multiple injuries. Eight of 16 cases of mesenteric injury （50％） had multiple injuries. Nine cases （30％） were in a state of shock at the time of arrival or during examination. Of these, 2 cases with retroperitoneal large vessel injury （1 with duodenal injury） and 1 case in shock due to bleeding from the ileocolic artery could not be saved. On the other hand, symptoms such as abdominal pain appeared 9 hours （median） after injury in 6 patients （20％）. In the treatment of intestinal and mesenteric injuries due to blunt abdominal trauma, it is necessary to pay attention to cases of comorbid retroperitoneal large vessel injury, multiple intestinal injuries, and delayed symptom onset.