**6.7. Gastrointestinal tract injuries**

Both penetrating and blunt injuries can cause gastrointestinal tract (GIT) injuries. Injuries to the GIT may be clinically difficult to detect and are more common with penetrating than blunt trauma. GIT injuries occur in 30% of stab wounds and in 80% of gunshot wounds to the abdomen [37].

In blunt trauma, an abdominal wall bruise or "seat belt sign" should raise the level of suspicion since the finding is associated with a GIT injury [38] (**Figure 8**).

GIT injuries may be missed on FAST examination or CT scan. The finding of free fluid in the abdomen on CT scan without a specific solid organ injury is highly suspicious of a hollow viscus injury [39].

Such injury may be present even if the patient can tolerate a trial of fluids by mouth in hospital care. Patients have been able to walk out of the hospital and return later with fever and a rigid abdomen [40].
