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Paterson-Brown S, Francis N, Whawell S, et al. Prediction of the delayed complications of intestinal and mesenteric injuries following experimental blunt abdominal trauma. Br J Surg. 1990;77(6):648-51doi: 10.1002/bjs.1800770619.
Paterson-Brown, S., Francis, N., Whawell, S., Cooper, G. J., & Dudley, H. A. (1990). Prediction of the delayed complications of intestinal and mesenteric injuries following experimental blunt abdominal trauma. The British journal of surgery, 77(6), 648-51. https://doi.org/10.1002/bjs.1800770619
Paterson-Brown, S, et al. "Prediction of the delayed complications of intestinal and mesenteric injuries following experimental blunt abdominal trauma." The British journal of surgery vol. 77,6 (1990): 648-51. doi: https://doi.org/10.1002/bjs.1800770619
Paterson-Brown S, Francis N, Whawell S, Cooper GJ, Dudley HA. Prediction of the delayed complications of intestinal and mesenteric injuries following experimental blunt abdominal trauma. Br J Surg. 1990 Jun;77(6):648-51. doi: 10.1002/bjs.1800770619. PMID: 2383732.
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Br J Surg. 1990 Jun;77(6):648-51. doi: 10.1002/bjs.1800770619.

Prediction of the delayed complications of intestinal and mesenteric injuries following experimental blunt abdominal trauma.

The British journal of surgery

S Paterson-Brown, N Francis, S Whawell, G J Cooper, H A Dudley

Affiliations

  1. Academic Surgical Unit, St. Mary's Hospital, London, UK.

PMID: 2383732 DOI: 10.1002/bjs.1800770619

Abstract

Injuries to the intestine and mesentery are often found in patients undergoing laparotomy for blunt abdominal trauma. Although treatment of perforations is relatively straightforward, the same is not true for contusions. Few guidelines exist at present to aid the surgeon in deciding which injuries require resection in order to avoid the complications of delayed perforation and late stricture formation. The natural history of these non-perforating intestinal and mesenteric injuries has been examined in an experimental model to identify possible criteria on which future management can be based. In the immediate postinjury period peristalsis and local mesenteric pulsation were absent in the majority of injuries which went on to full recovery and these observations are thus of little predictive value in predicting outcome. The initial size of contusion (length of contusion along longitudinal axis of bowel) relative to bowel wall circumference (BWC) was related to complications as follows: contusion less than BWC (n = 47)--one complication; contusion greater than BWC (n = 8)--three complications (P = 0.02). Similarly, six mesenteric injuries which produced an initial ischaemia (assessed by fluorescein) less than twice the BWC did not result in any complications, compared with four complications which occurred in ten cases when the initial ischaemia was greater than twice the BWC. These results go some way towards providing a better understanding of these injuries and in turn may help the emergency surgeon in deciding which injuries require resection.

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