TITLE:
Jejuno-Ileal Ruptures after Blunt Abdominal Trauma at the Teaching Hospital of Bouake
AUTHORS:
Kouakou Ibrahim Anzoua, Kouamé Bernadin Kouakou, Mamadou Traoré, Kalou Ismael Leh Bi, Alassane Binaté, Venance Dago Aloka, Blaise Amos Kouakou, Amos Serge Ekra, Roger Lebeau, Bamourou Diané
KEYWORDS:
Rupture, Jejunum, Ileum, Blunt Abdominal Trauma, Peritonitis, Hemoperitoneum
JOURNAL NAME:
Surgical Science,
Vol.13 No.3,
March
23,
2022
ABSTRACT: Objective: The aim of this study is to determine the causes, pattern, management, and outcome of jejunal-ileal rupture
following blunt abdominal trauma at the teaching Hospital of Bouake. Methods: The study included 27 patients who underwent laparotomy for jejunoileal
injuries from blunt abdominal trauma at the Teaching Hospital of Bouake over a
period of 14 years from January 2007 to December 2020. A retrospective study
was conducted and the patients were analyzed
with respect to patient demographics data, cause, injury mechanisms,
presentation, anatomical distribution, diagnostic methods, associated
injuries, treatment and outcomes. Results: During the
14 year period from 2007 to 2020, 27 patients with blunt small bowel injuries
were treated at our Teaching Hospital. That is 2.9% of all blunt abdominal
trauma. Male to female ratio was 4.4:1 and the average age was 26.3 years
(range: 15 and 50 years). The majority (66.7% 18 cases) were Victims of road
traffic accident. Median delay between injury and arrival at hospital for these patients was 10.1 hours (range: 1 - 72 h). A single intestinal injury was present in 22 patients, while 5 patients suffered from 2 injuries. There
were 32 perforations of the small intestine in 27 patients with two
perforations being transection. All perforations were located on the
antimesenteric border of the intestine. Out of the 32 jejuno-ileal ruptures 18
were located on the jejunum while 14 were located on the ileum. Associated
intra-abdominal injuries were present in 6 patients and nineteen associated
extra-abdominal injuries were present in 10
(70.4%) patients. A one-stage therapeutic strategy was performed in 20
cases (74.1%) and a two-stage strategy was performed in seven cases (25.9%). Intestinal
continuity was restored 93.8 days later (range 60 and 140 days). The average
length of hospital stay of the operated patients was 11.4 days. The operative
morbidity was 25.9%. Conclusion: Jejuno-ileal ruptures are rare and characterized by a
delay in management. An early diagnosis could improve the vital
prognosis of the patients.