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Small bowel injuries in children
Author(s) -
Holland A J A,
Cass D T,
Glasson M J,
Pitkin J
Publication year - 2000
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2000.00502.x
Subject(s) - medicine , perforation , surgery , blunt , abdominal pain , blunt trauma , abdomen , sepsis , bowel perforation , complication , materials science , punching , metallurgy
Objective : To determine the common features of small bowel injury (SBI) in childhood and the consequences of delayed diagnosis. Methodology : A retrospective case review was performed of children with traumatic SBI between January 1988 and November 1999. Results : Twenty‐eight patients were identified with SBI. Road trauma accounted for 71% of them. Tachycardia was present on admission in 82% of patients with SBI including all but one of the intestinal perforations. SBI was associated with a Chance fracture of the lumbar spine in three patients (11%). An abdominal computed tomography scan with intravenous contrast was abnormal in all patients with a perforation or mesenteric tear. Diagnosis was delayed in six patients, one of whom died as a result of sepsis from a small bowel perforation. Conclusions : Persistent tachycardia with an appropriate mechanism of injury following blunt abdominal trauma requires active exclusion of SBI. Delayed diagnosis is associated with significant morbidity and mortality.