Journal of Paediatrics and Child Health · 2000 · 27 citations · 35 references
MedicinePediatricsSurgeryPediatric Emergency CarePediatric Emergency MedicinePediatric RadiologyAbdominal ImagingAbdominal TraumaGastrointestinal PerforationPediatric TraumaTrauma ComplicationsTrauma ImagingBlunt Abdominal InjuryBlunt Abdominal Trauma PerforationChance FracturesContrastDelayed Imaging DiagnosisIntravenous Contrast ImagingSmall Bowel PerforationTraumatic Gastrointestinal Perforation
OBJECTIVE: To determine the common features of small bowel injury (SBI) in childhood and the consequences of delayed diagnosis. METHODOLOGY: A retrospective case review was performed of children with traumatic SBI between January 1988 and November 1999. RESULTS: Twenty-eight patients were identified with SBI. Road trauma accounted for 71% of them. Tachycardia was present on admission in 82% of patients with SBI including all but one of the intestinal perforations. SBI was associated with a Chance fracture of the lumbar spine in three patients (11%). An abdominal computed tomography scan with intravenous contrast was abnormal in all patients with a perforation or mesenteric tear. Diagnosis was delayed in six patients, one of whom died as a result of sepsis from a small bowel perforation. CONCLUSIONS: Persistent tachycardia with an appropriate mechanism of injury following blunt abdominal trauma requires active exclusion of SBI. Delayed diagnosis is associated with significant morbidity and mortality.
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Susan P. Baker, Brian O’Neill, William F. Haddon et al. · The Journal of Trauma: Injury, Infection, and Critical Care · 1974 · 7.3K citations