Multiple isolated small bowel perforations following blunt abdominal trauma.

INTRODUCTION: Small bowel injury is uncommon after blunt abdominal trauma. Repeated clinical assessment is important, especially when investigative imaging is negative. CASE PRESENTATION: 39-year-old male presented to the emergency department following a blunt abdominal trauma. No initial hemodynamic abnormalities were found. Abdominal CT scan was negative for small bowel perforation. Repeated clinical assessment revealed increasing abdominal pain with tachycardia, and an emergent laparotomy was undertaken. Four grade II and one grade I small bowel perforations were found, all repaired with interrupted sutures. Patient was discharged home on day 7. DISCUSSION/CONCLUSION: The diagnosis of small bowel injury is difficult and a low threshold of suspicion is crucial to reduce morbidity and mortality. Hemodynamic instability or abdominal tenderness after blunt abdominal trauma are indications for immediate surgical exploration, despite negative imaging findings. Serial clinical assessment is the main decision tool to perform an abdominal exploration.

Transit of radiopaque particles through the gastrointestinal tract: comparison between type 2 diabetes patients and healthy individuals.

BACKGROUND/AIMS: some studies have reported controversial results when comparing the gastrointestinal transit between diabetic and healthy individuals. Therefore, we compared the gastrointestinal transit of radiopaque particles between diabetic and non-diabetic healthy individuals. METHODS: abdominal radiographies were performed for 45 type 2 diabetes mellitus patients and 35 healthy individuals (gender and age similar for both groups) at 24 and 72 h after they ingested radiopaque particles. The mean number of particles in the colon was compared for both groups. The data were expressed as mean and standard deviation values. RESULTS: at 24 h, the total number of particles in the colon did not differ significantly for the diabetic and non-diabetic individuals. At 72 hours, the distribution in the diabetic and non-diabetic individuals was as follows: right colon, 0.44 ± 0.88 and 0.26 ± 0.7, respectively (p = 0.8); left colon, 2.6 ± 4.2 and 0.49 ± 1.3 (p < 0.003); and rectosigmoid colon, 2.65 ± 3.8 and 0.80 ± 1.5 (p < 0.005).The mean number of radiopaque particles in the entire colon was 5.7 ± 7.1 and 1.5 ± 2.7 for diabetic and non-diabetic individuals, respectively (p < 0.001). CONCLUSIONS: the number of radiopaque particles in the colon did not significantly differ for the diabetic and non-diabetic individuals at 24 h after ingestion but was significantly greater in diabetic individuals at 72 h after ingestion. At 72 h, the mean number of radiopaque particles in the left and rectosigmoid colon were significantly higher in the diabetics than in the non-diabetic individuals.

Transit of radiopaque particles through the gastrointestinal tract: comparison between type 2 diabetes patients and healthy individuals / Tránsito de partículas radiopacas a través del tracto gastrointestinal: comparación entre pacientes con diabetes tipo 2 y los individuos sanos

Background/aims: some studies have reported controversial results when comparing the gastrointestinal transit between diabetic and healthy individuals. Therefore, we compared the gastrointestinal transit of radiopaque particles between diabetic and non-diabetic healthy individuals. Methods: abdominal radiographies were performed for 45 type 2 diabetes mellitus patients and 35 healthy individuals (gender and age similar for both groups) at 24 and 72 h after they ingested radiopaque particles. The mean number of particles in the colon was compared for both groups. The data were expressed as mean and standard deviation values. Results: at 24 h, the total number of particles in the colon did not differ significantly for the diabetic and non-diabetic individuals. At 72 hours, the distribution in the diabetic and non-diabetic individuals was as follows: right colon, 0.44 ± 0.88 and 0.26 ± 0.7, respectively (p = 0.8); left colon, 2.6 ± 4.2 and 0.49 ± 1.3 (p < 0.003); and rectosigmoid colon, 2.65 ± 3.8 and 0.80 ± 1.5 (p < 0.005).The mean number of radiopaque particles in the entire colon was 5.7 ± 7.1 and 1.5 ± 2.7 for diabetic and non-diabetic individuals, respectively (p < 0.001). Conclusions: the number of radiopaque particles in the colon did not significantly differ for the diabetic and non-diabetic individuals at 24 h after ingestion but was significantly greater in diabetic individuals at 72 h after ingestion. At 72 h, the mean number of radiopaque particles in the left and rectosigmoid colon were significantly higher in the diabetics than in the non-diabetic individuals(AU)