Surgical experience of delayed intestinal necrosis following blunt abdominal trauma: 19 consecutive cases in 10 years

To summarize characteristics of delayed intestinal necrosis following blunt abdominal trauma seen in the past 10 years, to improve diagnostic accuracy and curative effects. We retrospectively analyzed clinical data from patients with delayed intestinal necrosis following blunt abdominal trauma, who were admitted to Shanghai Changhai Hospital affiliated with Second Military Medical University, China, between January 2004 and December 2014. All cases of intestinal necrosis were diagnosed surgically and pathologically. Clinical records from 19 delayed intestinal necrosis cases (1.82%) out of a total of 1043 patients with blunt abdominal trauma were reviewed. Injuries comprised 11 jejunum, 10 ileum and 5 colon injuries and the average length of intestinal injuries was 26.47 ± 34.26 cm. Eight patients had grade I or II surgical complications, and three patients developed abdominal bleeding and anastomotic leakage, which were treated by conservative or surgical management. Three patients developed severe intraperitoneal sepsis and died within one month after surgery. All patients with severe blunt abdominal trauma should be followed closely with repeated physical examinations to detect any signs of peritonitis. Tests for plasma fatty acid binding protein (FABP) levels, serial abdominal CT scans and timely exploratory laparotomy should be performed if necessary.