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February 1953

ACUTE BOWEL OBSTRUCTION: Forty Years After Blunt Trauma

Author Affiliations

From the Department of Surgery, St. Mark's Hospital.

AMA Arch Surg. 1953;66(2):167-170. doi:10.1001/archsurg.1953.01260030180005

THE LITERATURE contains numerous examples of blunt trauma to the abdomen which has resulted in injuries to all the viscera—not excluding even the gastric vessels1—but especially to the spleen, liver, kidney, bowel, and diaphragm. Little has been written, however, about delayed effects of the serious crushing injury upon which immediate operation has not been performed.

Spellberg and Ochsner2 in seeking a relationship between nonpenetrating trauma to the small bowel and regional enteritis, traumatized the small bowel of dogs at laparotomy by crushing. Autopsy on survivors several months later revealed marked adhesion formation with large ropes of fibrous tissue and compression of the bowel.

The most extensive reference found on the remote sequelae to blunt injury to the bowel is in Küttner's book, "Die Spätschädigungen des Darmes nach stumpfer Bauchverletzung"3 in which the literature is covered up to 1930. In 207 references to abdominal injury, only 21