Author/Editor		Vidmar, Dubravka; Pleskovič, Alojz; Tonin, Martin
Title		Diagnosis of bowel injuries from blunt abdominal trauma: our experience
Type		članek
Source		Eur J Trauma
Vol. and No.		Letnik 29, št. 4
Publication year		2003
Volume		str. 220-7
Language		eng
Abstract		Background: Patients with bowel injuries resulting from blunt abdominal trauma show no reliable clinical or radiologic signs on initial examination. The mechanism of injury is the only element of some diagnostic value. Intestinal injury may be evaluated by ultrasonography (US), plain abdominal radiographs, computed tomography (CT), and diagnostic laparoscopy. This paper is a retrospective study of diagnostic procedures used in 45 consecutive patients with bowel injuries who presented at our center between October 1996 and December 2001. Patients and Methods: Of 45 patients (mean age 40 years), nine suffered isolated bowel injuries and 36 presented with concomitant injuries.The mechanism of trauma was traffic accident in 30 of 45 patients (in 16 of these 30 patients compression by a seat belt), strong blow to the abdomen in eight, fall from a height in five. and other causes in two patients. US was done in 43 of 45 patients, plain abdominal radiographs in 22, CT in six, peritoneal lavage in one, and diagnostic laparoscopy in one. Results: 37 of 43 patients were evaluated by US immediately upon arrival; in four patients there was a delay in diagnosis of 1 day, and in two patients a delay of several days. At initial sonography, free intraperitoneal fluid was identified in 32 of the 43 patients; in most of them (n = 15) the amount of free fluid was rather small. Free fluid was absent in eleven of 43 patients; yet seven ofthese eleven patients demonstrated free fluid upon repeat examination. In nine of 32 patients, an increased amount of free fluid was identified upon repeat examination. Two of 43 patients, evaluated 3 and 9 days after arrival, respectively, showed dense intraperitoneal fluid, suggestive of peritonitis. US identified intestinal injuries in 14 of 43 patients; in all of them, the diagnosis was established upon repeat examination or delayed initial examination. (Abstract truncated at 2000 characters)
Descriptors		ABDOMINAL INJURIES WOUNDS, NONPENETRATING INTESTINES TOMOGRAPHY, X-RAY COMPUTED