Álvarez IS, Valdez GPA, López SAL, Escobedo AF, Basilio OA

Language: Spanish
References: 11
Page: 69-73
PDF size: 119.84 Kb.

ABSTRACT

Objectives: To analyze the experience of surgical treatment of small bowel injuries in the Surgery and Trauma Department in Central Hospital of the Mexican Red Cross and General Hospital “Rubén Leñero”. To compare surgical techniques and postsurgical morbimortality. Place: Third level attention General Hospitals. Design: Comparative, prospective and observational study. Patients and methods: We reviewed the clinical records of 101 patients divided in two groups: one of 51 and the other with 50 patients with abdominal trauma and intestinal injury registered from January 2003 to January 2006. We considered the following variables: Mechanism and grade of injury, gender, age, diagnosis, surgical technique, morbidity and mortality. All patients were clasiffied according to the American Association of Surgery and Trauma (AAST) small bowell injury scale. Results: In group 1 (Mexican Red Cross) there were 47 males and 4 females with an average age of 35 years (between 15 and 80 years old). Small bowel injury was caused by gunshot in 23 patients (45.09%) by stabbing in 18 patients (35.29%) and blunt trauma in 10 patients (19.60%). Injury class III was the most frequent with 17 patients (33.33%), followed by class IV with 14 patients (27.45%), II with 12 patients (23.52%), and V with 8 patients (15.7%). The most frequent surgical technique was two layer suture end to end anastomosis in 22 patients (43.13%). Morbidity was 3.92% in 2 patients with enterocutaneous fistulae, managed with total parenteral nutrition and closed spontaneusly in 6 weeks. Hospitalary stay was 5 days. Mortality was 0%. In group 2 (“Rubén Leñero” General Hospital) there were 40 males and 10 females with an average age of 33 years old (between 15 and 80 years old). Small bowel injury was caused by gunshot in 20 patients (40%), stabbing in 23 patients (46%) and blunt trauma in 7 patients (14%). Small bowel class IV was the most frequent with 17 patients (34%), followed by class II and III with 13 patients each one (26%), and class V with 8 patients (16%). The most frequent surgical technique was single layer suture end to end anastomosis in 24 patients (48%). Morbidity was 2% with 1 complicated patient with an enterocutaneous fistulae, managed with total parenteral nutrition and closed spontaneously in 6 weeks. Hospital stay was 5 days. Mortality was 0%. Conclusions: In this study we noted that single layer end to end enteroanastomosis has a low morbidity and mortality, is safe, cheaper and faster when compared with a two layer end to end intestinal suture is in the treatment of small bowel trauma.

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