Diagnosis and management of small bowel and mesentery injury following blunt abdominal trauma in 12 cases

Over four years [April 2004 to December 2008] 12 patients with blunt small bowel and mesenteric injuries were treated at three hospitals dealing with trauma. Ten cases were victims of traffic accidents, of whom 70% wore seat belts. There were 11 small bowel injuries [4 full-thickness and 7 seromuscular] and 9 mesenteric injuries [3 with and 6 without a de-vascularized bowel segment]. All were managed initially following the Advanced Trauma Life Support [ATLS] guidelines. Emergency room ultrasound was positive for blood in 5/7 cases [71%] and CT scan in 2/4 [50%]. Diagnostic peritoneal lavage [DPL] was performed in one case and was positive for blood