INTESTINAL INJURIES IN MOTOR VEHICLE CRASHES: THE FORGOTTEN INJURY

摘要

Blunt abdominal trauma from motor vehicle crashes (MVC) is the leading cause of hollow viscus injuries (HVI). HVI (small and large intestines) has an incidence of 1-8%. Diagnosing HVI is challenging and often delayed, placing the occupant at higher risk for morbidity and mortality. The purpose of this study is to determine the relationship between intestinal injuries and sources of injury in frontal crashes. Crash Injury Research and Engineering Network (CIREN) crashes including model years 1989-2007 were selected based on occupant demographics and crash characteristics. Injury patterns, causation and extent of the vehicle damage were analyzed. There were 1669 frontal collisions, in which 51 front seat occupants sustained a total of 67 HVI (31 colon, 36 small intestines). Sixty-seven percent (67%) of these occupants were appropriately belted, and 70% of the injuries were sourced to the seat belt while 29% were attributed to contact with the steering wheel. Utilizing crash kinematics and injury mechanisms in association with other signs and symptoms of abdominal injuries should increase suspicion to the possibility of HVI. Continued research defining abdominal injury thresholds and development of protective devices is required to reduce the frequency of these injuries.