BACKGROUND: Breakdown of intestinal repair and enteric leakage after @entity130 laparotomy can have dire consequences. Factors contributing to these failures when stratified according to location of @entity1944 and method of repair were examined. METHODS: We retrospectively reviewed all intestinal injuries occurring in a recent 2-year time span in adult @entity1 surviving for more than 48 hours at a Level I @entity130 center. Data included Injury Severity Score, @entity1661 Index score, site (stomach, duodenum, small and large intestine), and type of repair (enterorrhaphy vs. resection and @entity254 ). Physiologic parameters within 48 hours of repair were assessed. Nonparametric analysis was used with significance assessed at the 95% confidence interval. RESULTS: Two hundred twenty-two intestinal repairs in 171 @entity1 were evaluated. All repairs but one were performed at the initial surgery. Eleven (5%) of these failed in 11 @entity1 (6.4%)--four duodenum, four small bowel, and three colon--and were not recognized for an average of 15 days. Breakdown of repair occurred in @entity1 with higher Injury Severity Scores and @entity1661 Index scores (30 vs. 21 and 29 vs. 14, respectively; p < 0.001) and higher intraoperative blood and fluid administration (8.8 vs. 2.2 U and 11.5 vs. 5.1 L, respectively; p < 0.05). This was associated with longer intensive care unit and hospital stays (15.1 vs. 1.9 and 68.4 vs. 10.4 days, respectively; p < 0.001). All small bowel leaks occurred after resection and @entity254 versus enterorrhaphy (p < 0.05). All anastomotic breakdowns (four small bowel, one colon) occurred in the setting of massive blood and fluid administration versus those that did not leak (12.5 vs. 1.7 U and 12.7 vs. 5.8 L, respectively; p < 0.05). Four of 12 duodenal enterorrhaphies failed. All were associated with @entity660 versus none without (p < 0.05). The @entity8479 occurred in three @entity1 . In each case, breakdown of a small bowel @entity254 occurred. CONCLUSIONS: (1) Stomach repair and small bowel and large-bowel enterorrhaphy may be safely accomplished in any setting. (2) Associated @entity660 is a risk factor for disruption of duodenorrhaphy. (3) In @entity1 with massive blood and fluid administration, delay of bowel anastomoses should be considered. (4) Disruption of small bowel anastomoses is associated with @entity8479 .

Breakdown of intestinal repair after laparotomy for XXXX : incidence, risk factors, and strategies for prevention.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1944 :: ('MESH:D007410', 'Disease') :: ['intestinal injury'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity1661 :: ('MESH:D000008', 'Disease') :: ['Abdominal Trauma'] @entity660 :: ('MESH:D010182', 'Disease') :: ['pancreatic injury'] @entity8479 :: ('MESH:D059325', 'Disease') :: ['abdominal compartment syndrome'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity130 :: (MESH:D014947,Disease) :: ['trauma']
