Treatment of the Traumatic Perforation of the Gastrointestinal Tract

Shuzo Yamamoto

Department of Surgery, Saiseikai-kanagawaken Hospital and Kanagawaken Traumatic Center of the Traffic Accident

Traumatic injuries of the gastrointestinal (G.I.) tract (227 patients with perforation) between Augast 1965 and December 1991 were retrospectively investigated and analyzed. The treatment and the results were devided according to the injured organs. The G.I. tract injuries were roughly divided into duodenal, and colon and rectum injuries and their treatment was investigated. The traumas included 163 cases of blunt injury (7l.8%) and 64 cases of stab injury (28.2%). Injuries of the small intestine were most frequent and found in 141 cases, followed in order by the duodenum (43 cases), colon and rectum (37 cases) and stmach (30 cases). Stomach damage was most frequently caused by stab injuries and was treated by simple closure (78.1%) of the perforation. Treatment of duodenal injuries included simple closure (eight cases), jejunal serosal patch (eight cases) and diverticulization (24 cases). The selection of the most suitable method should depend on the site and severity of the injury, the presence of stomach contents and accompanying injuries. Injuries of the small intestine rarely cause problems but 75.7% of those of the large intestine required primary repair, suggesting its usefulness.

Key words
abdominal trauma, treatment of the duodenal injury, primary repair of the colon injury

Reprint requests
Shuzo Yamamoto Department of Surgery, Saiseikai, Kanagawaken Hospital
6-6 Tomiya-cho, Kanagawa-ku, Yokohama, 221 JAPAN

Accepted
October 7, 1992

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