Injury to the intestine can happen after a car crash, fall, bike wreck, or any activity that causes a hard blow to the abdomen.

A penetrating intestinal injury can be caused by a gunshot, knife, or other sharp object that punctures the intestine.

Intestines

The intestine has three functions:

• The first is to digest food that is eaten.
• The second is to absorb water, electrolytes and nutrients.
• The third is to help get rid of wastes from the body.

It starts at the opening of the stomach and ends at the anus or rectum.

The intestine is a long, slender, coiled tube. The first part is called the small intestine and the last part is the large intestine.

The small intestine is further divided into the duodenum, jejunum and ileum.

The large intestine is divided up into the ascending colon, transverse colon, descending colon, sigmoid colon and rectum.

Together, the small intestine (20 feet) and large intestine (5 feet) are about 25 feet long.

Diagnosis of Intestinal Injury

When the intestine is injured, the child may develop stomach pain and a tight, distended belly. If the material inside the intestine leaks out into the abdomen, it can cause a serious and possibly life-threatening infection. Some intestinal injuries do not cause symptoms right away but may develop after many hours or even days.

If an intestinal injury is suspected, the trauma surgery providers will thoroughly and carefully examine your child. X-rays, a computed tomography (CT) scan (more detailed x-ray), blood tests, or even a diagnostic laparoscopy surgical procedure can be done to diagnose an intestinal injury.

Treatment for Intestinal Injury

A child with crushed, torn, or punctured intestines may need surgery to fix the injury. Your child will not be able to eat or drink for some time after the procedure.

He / she will have an IV (a small tube in their vein) to receive IV fluid hydration. He / she may also have a nasogastric tube (a tube placed through the nose into the stomach) after surgery to keep their stomach empty so that gastric material does not pass through the repaired intestine site and the intestines have time to heal. Antibiotics and pain medication may be given to your child to prevent infection and control pain.

As your child gets better, the doctors and nurses will check for return of bowel function. Once this has happened, your child will be allowed to start drinking clear liquids and over time progress to regular foods. It is important to know that healing time is not the same for each child and it can be days before your child can eat regular food.

If the intestine was only bruised, your child will probably not need surgery, but he / she may need to stay in the hospital to be monitored closely.

Medications and Pain Management

Speak to your trauma surgery provider about medications your child was taking prior to their admission to the hospital and obtain approval to resume home medications. Your child may have some pain or soreness at home. Give Acetaminophen (also known as Tylenol) for pain. Your child's trauma surgery provider may also write a prescription for stronger pain medication. Give the stronger medication if the pain does not go away one hour after giving Acetaminophen. Follow the directions on the prescription.

Do not give your child NSAIDs or Ibuprofen (also known as Motrin, Advil, Aleve, etc.) until the trauma surgery provider says that it is okay. Your child may require a stool softener while taking prescription pain medication to prevent constipation and straining with bowel movements.

Wound and Skin Care for Intestinal Injury

Your child may take a quick shower two days after surgery but should not go swimming or take a tub bath for one week. No swimming in lakes, rivers, or oceans for two weeks. If your child has cuts or scrapes on the skin from other injuries, wash the areas with warm, soapy water and pat dry. If your child has stitches, follow the specific instructions given by the trauma surgeon on caring for them or any other injuries or wounds.

Activity after Intestinal Injury

Your child will not be allowed to go to gym class, recess, or play sports for some time after they leave the hospital. The amount of time will depend on the extent of your child’s injury. Your trauma surgery provider will talk to you about this before your child leaves the hospital. Your child should not play rough with family, friends, or pets while recovering. Your child may require some time off school to be at home to rest. Your trauma surgery provider will give you recommendations regarding going back to school.

Call Your Child's Doctor If:

Call the trauma clinic or seek medical attention if your child has:

• Increased or worsening abdominal pain
• Fever >100.5
• Difficulty with bowel movements
• Shortness of breath
• Nausea / vomiting
• Dizziness
• A fast heart rate
• Concern for wound infection (redness, swelling, pus drainage, or increased wound pain)

Emotional Recovery from Intestinal Injury

After the injury, your child may be tired and irritable. It takes time to heal. Use this time for rest and quiet activities.

Have your child play board games, read, or do small craft projects for short periods of time. Infants and toddlers are harder to distract and will be more difficult to confine.

Try putting your infant or toddler in a large crib or playpen. Ask family and friends to visit, but for short periods of time and not at the same time to minimize activity.

After any trauma children may experience acute stress symptoms that may be reflective of post-traumatic stress disorder (PTSD). If you notice your child having nightmares, flashbacks, nervousness, irritability or any other concerning emotional symptoms please speak with the trauma surgery provider. Short term therapy can be provided to help children heal and recover emotionally after a trauma.

Follow-Up after Intestinal Injury

Usually, no follow up tests are needed, however all children with an intestinal injury will be seen in the trauma clinic one or two weeks after discharge. An appointment will be made for you before you leave the hospital, or you will be given a number to call to make an appointment. The trauma clinic number is 513-636-8556.

Once it is okay for your child to return to normal activity, no further follow-up will be needed.

Preventing Intestinal Injury

It is very important to teach your child about all types of safety. Make sure your child is secured in an age-appropriate child restraint every time they ride in a vehicle. Children under 13 years old are safer in the back seat in the correct child restraint. For questions or to schedule a car seat safety check please call 513-803-7433.

Make sure your child wears the correct type of helmet when riding a bike, using other wheeled toys, or taking part in other active sports.

For more injury prevention tips and resources visit our Comprehensive Children’s Injury Center.