Small intestine rupture

Introduction to small bowel rupture Small intestine perforation caused by the action of various external forces is called small intestine rupture. Clinical manifestations include abdominal pain, bloating, and peritonitis, which may be associated with shock. The small intestine is located under most of the anterior wall of the abdomen, relatively shallow, with many chances of injury, and often has multiple lesions at the same time. Due to the thick wall of the small intestine and abundant blood supply, the success rate of perforation repair or intestinal resection and anastomosis is higher, and there is less chance of intestinal fistula. For patients with simple intestinal perforation and general condition, the "A" and "B" drugs are used for rehydration, anti-infection, and correction of water-electrolyte disorders. Once the diagnosis of small bowel rupture is determined, surgery should be performed immediately. The surgical method is based on simple repair. Intermittent lateral sutures are generally used to prevent stenosis in the intestinal lumen after repair. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: peritonitis shock

Cause of small bowel rupture

Violent factors (40%):

The small intestine rupture is caused by direct violence and indirect violence. It is mainly caused by rupture of the ileum caused by blunt abdominal injury, falling from a height or sudden deceleration. It is generally believed that the site of rupture is within 50 cm of the proximal jejunum and within 50 cm of the ileum from the ileum. Traumatic damage can generally be divided into closed intestinal injury, open intestinal injury and iatrogenic intestinal injury.

Intestinal rupture prevention

1. Avoid injury factors.

The management of small bowel trauma depends on its extent and extent. Fresh perforations or linear ruptures can be sutured. Large intestinal wall defects, severe contusion caused by loss of intestinal wall vitality or multiple perforations in a certain intestinal segment should be performed in part of the small intestine.

Mesenteric contusion, often leading to severe bleeding or hematoma formation. Treatment consists of proper hemostasis and removal of the intestinal segment resulting in poor circulation. Repair mesangial holes to prevent internal hemorrhoids. Occasionally, the main mesenteric artery is damaged, and reconstruction such as vascular repair or anastomosis should be performed. Wide intestinal resection should be avoided to cause short bowel syndrome. Mesangial vein collateral circulation is abundant, and it is generally prudent to not cause circulatory disturbance after ligation of large venous injury.

Blood tests showed an increase in white blood cell count, an increase in hematocrit, and a decrease in blood volume.

2. Examination of abdominal puncture fluid: The contents of the intestine are seen by the naked eye. The microscopic examination of white blood cells exceeds 5×108/L, and diagnosis can be made.

3. Examination of peritoneal lavage fluid: microscopic examination of leukocytes over 5×10 ⁸ /L suggests intestinal perforation, and red blood cells exceeding 1×10 ¹⁰ /L suggest internal bleeding. Amylases exceeding 128 genius units or greater than 100 sulphate units suggest pancreatic damage.

Complication of small intestine Complications peritonitis shock

Complications such as peritonitis, shock and poisoning may occur.

Peritonitis is a serious disease common to surgery caused by bacterial infections, chemical stimuli or injuries. Most of them are secondary peritonitis, which originates from abdominal organ infection, necrotic perforation and trauma. Its main clinical manifestations are abdominal pain, abdominal muscle tension, as well as nausea, vomiting, fever, severe blood pressure drop and systemic toxic reactions. If not treated promptly, it can die of toxic shock. Some patients may have pelvic abscess, intestinal abscess and underarm abscess, axillary abscess and adhesive intestinal obstruction.

Shock is a clinical syndrome characterized by acute and effective circulating blood volume caused by various serious pathogenic factors, with neuro-humoral factor imbalance and acute circulatory disorder. These pathogenic factors include major bleeding, trauma, poisoning, burns, asphyxia, infection, allergies, and heart pump failure.

Symptoms of small intestine rupture Common symptoms Abdominal pain, abdominal distension, bowel sounds disappeared Abdominal muscle tension Abdominal tenderness Mobility Voiced fever Fever abdomen sign Abdominal rebound

1. Abdominal pain, bloating, fever.

2. Abdominal muscle tension, total abdominal tenderness, rebound tenderness, mobile dullness (+), bowel sounds weakened or disappeared.

3. Severe cases may be accompanied by shock: mild signs of excitement in the case of primary symptoms and signs, such as clear consciousness, but irritability, anxiety, nervousness, pale skin, mild cyanosis of the lips and nails, heart rate Accelerate, increase respiratory rate, cold sweat, pulse speed, blood pressure can plummet, but also slightly lower, even normal or slightly higher, small pulse compression, decreased urine output.

Small bowel rupture

1. Blood test shows: increased white blood cell count, increased hematocrit, and decreased blood volume.

2. Examination of abdominal puncture fluid: The contents of the intestine are seen by the naked eye. The microscopic examination of white blood cells exceeds 5×10 ⁸ /L, and the diagnosis can be made.

3. Examination of peritoneal lavage fluid: Microscopic examination of leukocytes exceeding 5×10 ⁸ /L suggests intestinal perforation, and red blood cells exceeding 1×10 ¹⁰ /L suggest internal bleeding. Amylases exceeding 128 genius units or greater than 100 sulphate units suggest pancreatic damage.

Diagnosis of small intestine rupture

Diagnose based on

1. A clear history of abdominal trauma.

2. The above clinical manifestations.

3. Abdominal puncture (+), abdominal X-ray examination showed a sign of pneumoperitoneum.

After the small intestine rupture, only a small number of patients have pneumoperitoneum. Therefore, if there is no pneumoperitoneum, the diagnosis of small intestine perforation cannot be denied. - Some patients have small intestinal stenosis, or are blocked by food debris, fibrin or even prominent mucosa after piercing, and may not have diffuse peritonitis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.