Trauma to the intestine or intestinal injury is associated with abdominal trauma and injury. When there is a blunt or penetrating injury to the abdominal organs, it can lead to injury to the intestine. Abdominal injury poses a risk of severe blood loss and infection. Diagnosis of blunt trauma is often difficult and even missed out sometimes and is found predominantly in rural areas. Penetrating injuries are evident and found in urban areas.
The common sites of bowel injury are jejunum, ileum, colon which includes cecum, transverse colon and sigmoid colon. Bowel injury including mesenteric injury mechanisms can be crush and compression types or shearing and burst types. There can be active bleeding from the laceration and mesenteric hematoma. The small intestine forms a large part of the abdomen and can be intensely damaged in a penetrating injury. Bowel injury carries risk factors of infection, bowel obstruction, abscess and formation of fistula and more often requires surgery.
CT scan is conducted to detect hollow viscous injuries. CT scanning helps to avoid unnecessary laparotomies.
X-ray helps in determining the path of the penetration and if there is any foreign object left behind in the wound.
Peritoneal lavage is a procedure where a catheter is placed in the peritoneal cavity and any fluid present is aspirated and the area examined for blood and other material.
Diagnostic laparotomy and diagnostic laparoscopy are performed if other methods are not conclusive.
Ultrasound helps to detect the presence of fluid or spill of any gastrointestinal contents in the abdominal cavity.
Trauma to the intestine will require surgical treatment at the earliest