Intestinal disruption due to blunt abdominal trauma.

Twenty-three patients with thirty-one disruptions of the intestines due to blunt abdominal trauma are reviewed. The bowel disruptions occurred in the stomach (2 perforations), duodenum (9), proximal jejunum (18), and sigmoid colon (2). The causes of injury, diagnostic difficulties, delays in treatment, associated trauma, surgical correction, and results are analyzed. Deaths (4) and complications (6) are presented in detail. Intestinal disruptions can be due to a variety of types of blunt trauma, with the automobile being the most common etiologic agent. The bowel can perforate anywhere in its course. Intestinal perforations are often associated with severe injuries which will probably be the determining factors in survival. Persistence, particularly repeated physical examination, is required for the diagnosis of bowel injury. Routine diagnostic tests for duodenal injury are not reliable. Retroperitoneal hematomas around the duodenum must be explored. The injuries themselves are easy to repair, and repair is secure when performed at the primary operation. Prophylactic antibiotics are recommended.