If the diagnosis is in question, serial examinations and ultrasound might allow avoidance of computed tomography.
Delay in diagnosis of blunt intestinal injury, especially perforation, increases morbidity in adults, but whether this applies to children is not known. Researchers conducted a retrospective chart review of patients younger than 15 years with blunt intestinal injury that was diagnosed by laparoscopy or autopsy at 18 hospitals from 2002 through 2007. Patients were grouped according to time from injury until laparotomy (<6 hours, 6–12 hours, >12 hours) and presence of bowel perforation.
Among the 214 patients identified, the most common mechanisms of injury were motor vehicle collision (48%) and bicycle crash (17%). Time to laparotomy was <6 hours in 38% of patients, 6–12 hours in 30%, and >12 hours in 31%. Mean injury severity scores were sig…