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Journal of the Korean Society of Traumatology 2003;16(1):50-57.
Small Bowel Injury after Blunt Abdominal Trauma: An Analysis of Diagnostic Methods
Jae Woon Lee, M.D., Jin Whan Kim, M.D., Jang Ho Kim, M.D.*, Hae Chang Jo, M.D., and Byung Jo Bae, M.D.
Department of General Surgery, Department of Diagnostic Radiology*
Daegu Fatima Hospital, Daegu, Korea
둔상에 의한 소장 천공의 임상적 분석 및 진단적 도구로서의 CT의 유용성 평가
대구 파티마 병원 외과, 진단 방사선과*
Background: Although small bowel rupture has been reported to be the third most common injury in blunt abdominal trauma, but small bowel injury is an infrequent diagnosis, and there is not much agreement on how to make the diagnosis. The purpose of this study was to evaluate methods for making the diagnosis of blunt small bowel injury. Materials and Methods: The charts of 45 patients with small bowel injury by blunt trauma who were admitted to the Department of General Surgery of Daegu Fatima Hospital from January 1998 to December 2002 were reviewed. Each record was reviewed for detailed history, laboratory findings, and diagnostic methods. Results: A total of 45 patients who had small bowel perforations were included in this study. Forty-two had an abnormality on physical examination (93.3%). Thirty-four had CT abnormalities (75.6%). Thirty-two had leukocytosis (71.1%). Of the thirty-four patients with CT abnormalities, twenty had bowel-wall thickening, twenty-six had free air, and eighteen had fluid collection. Delays in the diagnosis of small bowel perforation are directly responsible for one-third of the deaths. Conclusion: Blunt small bowel perforation after trauma is relatively uncommon. When it is present, the results of physical examination, laboratory test (CBC), abdominal CT have to be considered initially.
Key Words: Small bowel injury; Blunt abdominal trauma; Diagnostic methods


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