Delayed intestinal perforation after nonpenetrating abdominal trauma
Winton, T.L.; Girotti, M.J.; Manley, P.N.; Sterns, E.E.
Canadian Journal of Surgery. Journal Canadien de Chirurgie 28(5): 437-439
1985
ISSN/ISBN: 0008-428X PMID: 3875386 Document Number: 267268
The incidence of hollow-organ injury has increased steadily since the use of seat-belts was introduced. It has become apparent that the clinical manifestations of intestinal injury may be delayed considerably. Delayed perforations can pose a diagnostic challenge to the attending surgeon. The authors report four patients who suffered delayed intestinal perforation 6 or more days after sustaining nonpenetrating abdominal trauma in motor vehicle accidents while wearing passive seat-belt restraints. All patients had low severity of injury (scores ranging from 4 to 13) but had persistent vague abdominal pain before perforation occurred. Three of the four patients suffered spinal trauma as their major initial injury. Such patients appear to be at higher risk for delayed perforation and should be monitored carefully.