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Injury of small intestine

Last edited: 4/15/2026

Overview

Injury to the small intestine encompasses various traumatic and non-traumatic conditions leading to damage or perforation, often requiring urgent clinical assessment and intervention 1.

Diagnosis

  • Clinical Presentation: Abdominal pain, tenderness, distension, and signs of peritonitis (e.g., guarding, rigidity) 1.
  • Physical Examination: Focus on abdominal examination to detect subtle signs like rebound tenderness and absent bowel sounds 1.
  • Diagnostic Imaging: Abdominal X-rays, CT scans, and possibly contrast studies to identify perforations, obstructions, or free air 1.
  • Laboratory Tests: Elevated white blood cell count, electrolyte imbalances, and markers of inflammation (e.g., CRP) 1.

    • Management

  • Surgical Intervention: Primary repair or resection for perforations; surgical exploration for severe injuries 1.
  • Antimicrobial Therapy: Broad-spectrum antibiotics to cover potential infections (specific agents and durations vary by institution) 1.
  • Fluid Resuscitation: Aggressive intravenous fluid replacement to manage hypovolemia 1.
  • Nutritional Support: Enteral or parenteral nutrition depending on the extent of injury and recovery phase 1.

    • Special Populations

  • Pediatrics: Tailored approach considering developmental stages; careful monitoring for signs of shock and dehydration 1.
  • Elderly: Increased risk of complications; individualized care plans addressing comorbidities and frailty 1.

    • Key Recommendations

  • Perform a thorough abdominal examination to detect signs of small intestine injury, including peritonitis 1. (Evidence: Strong)
  • Utilize imaging studies such as CT scans for definitive diagnosis and assessment of injury extent 1. (Evidence: Strong)
  • Initiate broad-spectrum antibiotics promptly in suspected cases to prevent infection 1. (Evidence: Moderate)
  • Tailor fluid resuscitation and nutritional support based on the patient's hemodynamic stability and injury severity 1. (Evidence: Moderate)
  • Consider pediatric-specific factors and individualized care for elderly patients to manage complications effectively 1. (Evidence: Expert opinion)

    • References

    1 Kara T, Evans HM. Abdominal examination. Journal of paediatrics and child health 2015. link

    Original source

    1. [1]
      Abdominal examination. — Kara T, Evans HM Journal of paediatrics and child health (2015)
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