Posttraumatic small bowel obstruction in children.
BACKGROUND
The diagnosis of intestinal injuries in children after blunt abdominal trauma can be difficult and delayed. Most children who suffer blunt abdominal trauma are managed nonoperatively, making the diagnosis of intestinal injuries more difficult. We sought to gain information about children who develop intestinal obstruction after blunt abdominal trauma by reviewing our experience.


METHODS
Review of records from a pediatric tertiary care center over an 11.5-year period revealed 5 patients who developed small bowel obstruction after blunt trauma to the abdomen. The details of these patients were studied.


RESULTS
All patients were previously managed nonoperatively for blunt abdominal trauma. Intestinal obstruction developed 2 weeks to 1 year (median, 21 days) after the trauma. Abdominal x-ray, computerized tomography scan, or barium meal studies were used to establish the diagnosis. The pathology was either a stricture, an old perforation, or adhesions causing the intestinal obstruction. Laparotomy with resection and anastomosis was curative.


CONCLUSIONS
Posttraumatic small bowel obstruction is a clinical entity that needs to be watched for in all patients managed nonoperatively for blunt abdominal trauma.
Jones
Vinci S
VS
Department of Academic Surgery, The Children's Hospital at Westmead, Westmead, Sydney 2145, NSW, Australia. vincijones@yahoo.co.in
Soundappan
Soundappan V S
SV
Cohen
Ralph C
RC
Pitkin
John
J
La Hei
Erick R
ER
Martin
Hugh C
HC
Cass
Daniel T
DT
D000007:Abdominal Injuries / Q000150:complications* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007583:Jejunum / Q000098:blood supply / Q000293:injuries; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000628:therapy