Small bowel injuries in children.
OBJECTIVE
To determine the common features of small bowel injury (SBI) in childhood and the consequences of delayed diagnosis.


METHODS
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.
Holland
A J
AJ
Department of Surgical Research and Douglas Cohen Department of Paediatric Surgery, The New Children's Hospital, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia.
Cass
D T
DT
Glasson
M J
MJ
Pitkin
J
J
D000293:Adolescent; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007421:Intestine, Small / Q000293:injuries* / Q000601:surgery; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000601:surgery; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000601:surgery