Isolated perforations of the small bowel from blunt abdominal trauma. Report of two cases and review of the literature.

On account of two recent cases, the authors present a review of the literature of small bowel isolated perforations following blunt abdominal trauma. Although these injuries are quite rare and their management relatively easy, the diagnostic approach is often hazardous and may lengthen the operative delay, worsening morbidity and mortality. The authors review the various physiopathological mechanisms (deceleration, crushing and rupture phenomena) responsible for small bowel perforations, as well as the predisposing factors. They emphasize the multiple pitfalls of the diagnosis and try, through a study of the literature, to establish systematic guidelines. The advantages and deficiencies of the various complementary investigations are discussed. The authors conclude with indications of conservative treatments and segmentary enterectomies respectively.