Trauma and gastrointestinal complications

Modern advances in the acute transport, resuscitation, evaluation, and definitive therapy of trauma patients has dramatically enhanced survival. However, a subpopulation of critically ill trauma victims require protracted critical care and may suffer from progression of the syndromes of systemic inflammatory response and multiple organ dysfunction. A missed diagnosis of primary intra-abdominal pathology or secondary GI dysfunction may increase trauma-related morbidity or mortality. Focus on the GI tract and the development of intra-abdominal pathology is crucial to modern critical care. Various measures such as stress ulcer prophylaxis and early enteral alimentation to maintain caloric intake, GI integrity, and limit complications related to parenteral hyperalimentation are important to consider. Also, newer developments with SDD, tonometry of GI intramucosal pH, imaging techniques, and interventional procedures should be followed with interest.