Small bowel stricture following blunt abdominal trauma.

BACKGROUND/AIM: Late presentation of small bowel strictures following blunt abdominal trauma is rather uncommon and there have been few previous reports of its occurrence. Most patients with blunt abdominal trauma without perforation or major bleeding are managed conservatively, making the diagnosis of less conspicuous intestinal injuries difficult.

METHODS

We reviewed our prospectively maintained surgical records over a period of 12 years and found that 8 patients developed small bowel obstruction subsequent to a history of blunt trauma abdomen which had been initially managed conservatively.

RESULTS

A total of 7 males and 1 female with a mean age of 37 (range 23 - 48) years were examined in this study. The most common presentation was pain and vomiting with abdominal distension, noted in 5 patients; but three patients presented only with abdominal pain. The strictures were solitary in all cases, with the most common site being the terminal ileum. The average interval between the trauma and presentation of small bowel obstruction was 138 (range 7 to 550) days. Barium meal studies and computerized tomography were used to establish the diagnosis and laparotomy with resection of the involved bowel was curative. There was no mortality.

CONCLUSIONS

Post traumatic small bowel obstruction should be kept in the differential diagnosis of patients who presented with abdominal pain, sometimes without distension and vomiting, and who have a history of blunt trauma abdomen.