title: Small bowel injuries in penetrating abdominal trauma during war: ten-year follow-up findings.
abstract: BACKGROUND
  Injuries of the small intestine are common in penetrating abdominal trauma. This article presents 10-year follow-up results for 23 patients with penetrating small bowel injuries who were treated in Nova Gradiska City Hospital during the 1991-1992 war in Croatia. The early hospital mortality rate was 13% (three deaths), and good results were found for 16 (84%) of 19 patients after 10 years.
  
  
  METHODS
  The hospital charts of 23 patients who sustained small bowel injuries during an 8-month period were reviewed. Of 20 patients who survived, 19 came for an examination and interview 10 years after injury. The following criteria were used: existence of an abdominal wall defect or hernia, bowel passage problems, and reoperations attributable to the small bowel injury.
  
  
  RESULTS
  Early results revealed adhesive peritonitis and ileus for three patients demanding early reoperation (13%) and a hospital mortality rate of 13% (three deaths, mainly attributable to multiple injuries). Ten years after injury, 16 patients had no problems, whereas 3 reported occasional abdominal pain.
  
  
  CONCLUSIONS
  Penetrating abdominal injuries in war demand urgent diagnostic procedures and, in almost all cases, urgent laparotomy. In cases with no evidence of abdominal penetration and cases involving multiple injuries, an aggressive approach reduces the risk of missing small bowel injuries. Use of established principles for surgical management of small bowel injuries yields good results and low incidences of late complications and difficulties.
authors.affiliation: Department of Surgery, University Hospital Dubrava, Zagreb, Av. G. Suska 6, HR- 10040 Zagreb, Croatia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Busić
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Lovrić
authors.forename: Enio
authors.initials: E
authors.lastname: Amić
authors.forename: Dubravka
authors.initials: D
authors.lastname: Busić
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Lovrić
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000601:surgery; D000328:Adult; D017523:Croatia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000601:surgery; D007421:Intestine, Small / Q000293:injuries*; D007813:Laparotomy; D008297:Male; D014193:Trauma Centers; D014857:Warfare; D014950:Wounds, Penetrating / Q000150:complications* / Q000601:surgery