The diagnosis of bowel rupture is made by finding free air on abdominal x-ray. Use a decubitus or cross-table view for the patient who cannot stand for an upright view. Duodenal or sigmoid colon injury may result in retroperitoneal air only. Peritoneal lavage will show WBCs and intestinal content, except for retroperitoneal duodenal or sigmoid rupture. Contrast examination may be required in equivocal cases, if surgery is not indicated for another reason.
Surgical repair is required.
Back to Menu Pancreas Injury Pancreatic injury is notoriously difficult to diagnose. Most cases are discovered only at surgical exploration. The injury should be suspected after a localized blow to the mid-abdomen, such as motorcycle handlebars or steering wheel. Pancreas injury has a high mortality. Duodenal or biliary duct injury are often present as well.