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preLekára.sk / Journals / Perspectives in Surgery / 2019 - 8

Injuries of the small and large intestine

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Authors: J. Rosendorf 1,2;  R. Pálek 1,2;  H. Mírka 3;  V. Třeška 1;  V. Liška 1,2
Authors place of work: Chirurgická klinika Lékařské fakulty v Plzni, Univerzita Karlova 1;  Biomedicínské centrum Lékařské fakulty v Plzni, Univerzita Karlova 2;  Klinika zobrazovacích metod Lékařské fakulty v Plzni, Univerzita Karlova 3
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 8, s. 315-320.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2019.98.8.315–320

Summary

Introduction: Patients with abdominal trauma appear frequently. The most vulnerable organs in these patients are the liver and the spleen. Injuries of the small and large intestines are relatively less frequent. The diagnostic process of these injuries is complex and requires an analysis of all results. Therefore it is highly probable that the final diagnosis can be delayed and so can be delayed an indication of surgical exploration of the abdominal cavity, which can have serious consequences on the morbidity and mortality of these patients with intestinal trauma.

Methods: We collected our data using the WinMedicalc 2000 software. We searched for patients hospitalised in years 2008−2017 in the Department of Surgery, Faculty of Medicine in Pilsen subjected to surgical revision of the abdominal cavity for intestinal trauma.

Results: Our set comprised 41 patients, including 30 men and 11 women. The mean age of the patients was 41 years, 4 of the patients were children. Twenty-three of the patients suffered from polytrauma, while 9 of the patients had a relatively isolated injury of either the small intestine or the colon. Six of the patients died. The small intestine was injured in 17 patients, the colon was injured in 14 patients and both were injured in 10 patients. The intestinal injury was diagnosed in 17 cases based on CT imaging (performed 31 times in total); 23 cases were diagnosed in the peroperative period.

Conclusions: We assessed a set of patients with an intestinal injury in terms of specific diagnosis, severity of trauma, diagnostic process and treatment. The results are similar to the results of studies in large sets of patients. Even though imaging methods can help to reach the right diagnosis, they are insufficient as a sole diagnostic method, and physical examination plays a major role.

Keywords:

diagnosis – abdominal trauma – intestinal injury – bowel injury – polytrauma

Zdroje
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Perspectives in Surgery

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