Diagnosis and treatment of intestinal injuries

ZHANG Xiao; WU Xing; WANG Li-min; WU Jian-jun; HAN Jun-yi; ZHAO Zhong-xin

doi:10.3969/j.issn.1009-4237.2017.09.003

Abstract：Objective To discuss the diagnosis and treatment methods for intestinal injuries.Methods 57 patients with intestinal injuries admitted to General Surgery Department of Liyang People`s Hospital from 2008 to 2017,were collected for retrospective analysis.Traumatic small intestinal injuries were often presented in middle-aged men.Among the patients,there were 23 caused by traffic accidents(44.23％),10 by blunt injury(19.23％) and 8 by falling accidents(15.38％),6 by sharp injuries (11.53％),5 by bruise (9.61％),5 by other unknown reasons (9.61％).The study revealed that 28 cases (49.12％) of the injuries were located in the jejunum,and 29 cases (50.87％) were located in the ileum.Purulent liquid or non-condensable blood could be found by abdominocentesis and free intraperitoneal air could be found by CT or X-ray.If progressively aggravating abdominal pain was sustainable and could be relieved,intestinal injuries should be considered.These patients might have injured hollow organ or substantial viscera injury.Intestinal repair was selected in 46 cases (80.70％) and small intestine ablation in combination with anastomosis was selected 11 in cases (19.30％) based on damaged parts and damage degree.Results Ten patients among 57 patients developed complications.Gradual Logistic Regression was used to analyze the prognosis of these patients.Results showed that blood loss volume was the influence factor of postoperative complications(OR=8.625).Conclusion Intestinal injuries were often caused by violent factors,such as traffic accidents.Relevant complications might be related to blood loss volume,indicating that when disposing intestinal injuries,improvement of intestinal injury diagnosis probability and reduction of operation time of patients can reduce occurrence of postoperative complications.