[Traumatic perforation of the small intestine in childhood].
BACKGROUND
Traumatic perforation of the small bowel occurs in approximately 1 percent of children with either blunt or penetrating trauma to the abdomen. Difficulty in recognition of initial subtle signs of hollow viscus injury can lead to delay in both diagnosis and operative intervention.


METHODS
Medical records for patients discharged with traumatic small bowel perforation from the General Surgery Department between 1991 and 1999 were reviewed.


RESULTS
Bowel injuries were noted in 41 children. Blunt trauma (battered child syndrome, bike injuries, etc.), was responsible for 37 cases and penetrating wounds in three (firearm wounds and bike pedal accidents). There were 32 boys and a mean age of 6.8 years. The site of perforation was duodenal in four cases, jejunum in 21, and ileum in sixteen. Associated injuries occurred in 11 patients, including stomach, pancreas, liver, spleen, bladder, and ureter. Twenty-nine had simple closure, while seven were resected. Four children died.


CONCLUSIONS
These injuries require prompt surgical intervention and are in general curable with excellent prognosis if one is alert to the possibility of their occurrence, if one is familiar with the approaches to prompt and accurate diagnosis, and if associated injuries are not serious.
Baeza-Herrera
C
C
Departamento de Cirugía General del Hospital Pediátrico Moctezuma, México, D.F.
García-Cabello
L M
LM
Gardida-Chavarria
R
R
Fernández-Corte
M G
MG
Osorio-Agüero
C D
CD
D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology; D007421:Intestine, Small / Q000293:injuries*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D012421:Rupture