Isolated bowel injury in blunt abdominal trauma in childhood.

From a total of 734 children with a blunt abdominal trauma admitted to the hospital in the past 15 years, 21 patients (3%) sustained an isolated injury of the bowel (8 duodenal, 9 jejunal and 4 colon ruptures). All patients were laparotomized without a postoperative mortality. Accompanying abdominal injuries were seen only in duodenal ruptures (pancreatitis and one choledochal and pancreatic ruptures). In 85% the blunt violence was caused by bicycle accidents due to the handle bar, in one case by a car accident and in 3 children by falls. Accurate diagnosis was only possible regarding the history, the mechanism of the accident and an exact repeated clinical examination. Despite further investigations of blood chemistry laboratory findings, ultrasound and x-ray, no further confirmation of the diagnosis could be achieved. Complications, occurring in 14% of our patients, were not related to the trauma itself, but caused by a delayed diagnosis and therapy.