Intestinal stenosis causing small bowel obstruction after nonoperative management of blunt abdominal trauma

Over the past few decades, surgical management of blunt abdominal trauma has shifted from operative to selective nonoperative. This trend to nonoperative management was driven by the fact that in 30% of laparotomies following blunt abdominal trauma, no intraabdominal procedure was carried out.(1) Nonoperative management of blunt liver and splenic injuries is accepted 2 and eliminates complications associated with nontherapeutic laparotomies. However, any benefit of selective nonoperative management should be weighted against the consequences of missed injuries and delayed diagnosis. We present a case of blunt abdominal trauma that was treated nonoperatively. Despite the success of initial treatment, the patient suffered from recurrent abdominal pain during the following year and underwent two abdominal operations.