Gastric perforations from abdominal trauma.
BACKGROUND
Gastric rupture due to abdominal trauma is rare (0.02-1.7%); it is usually caused by traffic accidents. Delayed diagnosis, abdominal contamination and associated lesions cause morbidity and mortality.


METHODS
Retrospective review of 2,083 patients with abdominal traumatism treated at our center over 20 years. We reviewed recent ingestion of a meal, etiology, time to surgery, site, Stomach Injury Scale, abdominal contamination, treatment, associated injuries, complications and mortality.


RESULTS
Gastric perforation occurred in 25 patients (1.2%), median age 35 years. Stomachs were distended from recent meals in 16 (64%). The commonest causes were traffic accidents (n = 13) and blunt weapon injury (n = 7). The median time to surgery was 1 h. Gastric lesions occurred predominantly in the anterior wall (n = 12) followed by the greater curvature (n = 7). Type II lesions repaired with simple suturing were the most usual. Abdominal contamination occurred in all cases. Associated lesions were present in 22 patients; the most commonly affected intra-abdominal organ was the liver, and the lungs were the most affected extra-abdominal organ. The morbidity rate was 60% (n = 15) and the mortality rate 4% (n = 1).


CONCLUSIONS
Early diagnosis and surgical treatment are important for reducing the morbidity and mortality in these patients.
Rodríguez-Hermosa
José Ignacio
JI
Department of General Surgery, University Hospital Dr. Josep Trueta, Girona, Spain. joserod@eresmas.net
Roig
Josep
J
Sirvent
Josep Maria
JM
Codina-Cazador
Antoni
A
Gironès
Jordi
J
Puig
Josep
J
Osorio
Margarita
M
D000007:Abdominal Injuries / Q000150:complications*; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013275:Stomach Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery