A Study of Traumatic Small Intestinal Perforation: What Factors Determine Outcome?

ABSTRACT

Introduction: Small bowel injury is common after blunt and penetrating abdominal trauma resulting in significant mortality andmorbidity in a generally active population. Delay in diagnosis and treatment results in a worse outcome. Our study aims todelineate the magnitude of the problem in a tertiary care teaching hospital and determine the factors resulting in a poor outcome.Materials and Methods: This institution-based, observational descriptive study was conducted over a period of 15 months. Thesample included patients with blunt or penetrating abdominal, trauma with small intestinal perforation. Patients with concurrentmajor CNS, cardiothoracic, and orthopedic trauma were excluded from the study. Various factors likely to affect final outcomewere recorded. The appropriate surgical procedure was performed and post-operative recovery and any complications includingmortality data were recorded and analyzed.Results and Analysis: A total of 38 patients were included. Males outnumbered females. Mean age of presentation was 32.03years signifying a younger population. Motor vehicle accidents and blunt trauma were more common. Mortality rate was 18.4%.The presence of shock at admission and death was significantly related. Delay in surgery significantly increased the length ofhospital stay.Conclusion: Small intestinal perforation resulting from abdominal trauma is a condition associated with a very high mortalityand morbidity, especially in a young and active population. The efforts to reduce its incidence are beyond this discussion, butmeasures to reduce its resultant mortality and morbidity are definitely possible and feasible in a well-equipped, tertiary caresetting. This requires sincere, well-concerted efforts from all strata of government including health caregivers.