Perforation of the small intestine caused by various external forces is referred to as small intestine rupture. The main clinical manifestations include abdominal pain, abdominal distension and fullness, and peritonitis, which may be accompanied by shock. The small intestine is located beneath most of the anterior abdominal wall, relatively superficial, with a high chance of injury, and often has multiple simultaneous damages. Due to the thick wall and rich blood supply of the small intestine, both perforation repair and segmental resection with anastomosis have high success rates, with a low chance of intestinal fistula formation.

bubble_chart Clinical Manifestations

1. Abdominal pain, abdominal distension and fullness, fever. 2. Abdominal muscle rigidity, generalized abdominal tenderness and rebound tenderness, shifting dullness (+), decreased or absent bowel sounds. 3. Severe cases may be accompanied by manifestations of shock.

bubble_chart Diagnosis

1. Clear history of abdominal trauma. 2. The aforementioned clinical manifestations. 3. Positive peritoneal puncture, and abdominal X-ray shows signs of pneumoperitoneum. [Treatment Principles] 1. Prevention and treatment of shock. 2. Anti-infection measures. 3. Correction of typical edema and electrolyte imbalances. 4. Surgical intervention.

bubble_chart Treatment Measures

The diagnosis of small intestine rupture is usually not difficult, but in some cases, the tear is small or the perforation site is blocked by adhesions such as the greater omentum, resulting in minimal leakage of intestinal contents. Consequently, symptoms may be mild and signs atypical, with no evidence of pneumoperitoneum on X-ray, leading to potential misdiagnosis. The key to successful surgery lies in thorough and meticulous exploration to avoid missing the site of rupture. For small tears, simple repair may suffice; for multiple tears concentrated in one segment of the intestine, resection and anastomosis may be necessary.

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1. Cure: After surgical treatment, symptoms and signs disappear, the wound heals, and there are no complications. 2. Improvement: After surgical treatment, the general condition improves, but there is wound infection or sinus formation. 3. Not cured: Postoperative complications such as intestinal fistula or severe abdominal infection remain, requiring intermediate-stage [second-stage] surgery.