Rupture of the bowel
Rupture of the small bowel is generally treated by simple closure of the defect.
Rupture of the large bowel may be closed in a similar manner. Some centres draw up a colostomy primarily, with the definitive repair occurring later.
The exception to the rule is duodenal damage:
- rupture of the duodenum is often diagnosed late
- simple closure has a high complication rate
- an alternative strategy involves division of the duodenum with closure of the ends and the formation of a gastro-enterostomy
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