Small bowel stenosis following blunt abdominal trauma: a case report

Prince, Sheela; Busharar, Hajer A.; Alzoabi, Osama M.

doi:10.1002/ccr3.1176

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Uncommonly, blunt trauma can result in mesenteric injury, local bowel ischemia, or internal stenosis of the intestinal tract due to intestinal mucosal infarction, which can lead to mechanical obstruction. [ 2 , 10 ] However, as in this case, there is a difference in the mechanism of mechanical obstruction caused by intestinal herniation due to traumatic vertebral fractures or dislocations. In cases of bowel obstruction due to intestinal stenosis, symptoms may appear delayed.…”

Section: Discussionmentioning

confidence: 93%

“…In cases of bowel obstruction due to intestinal stenosis, symptoms may appear delayed. [ 10 ] However, in most cases, when the intestine is caught between the dislocated or fractured vertebrae, symptoms of obstruction are mainly observed at the early stage of trauma, and in severe cases, it is accompanied by bowel perforation. [ 3 , 4 , 7 , 11 ] If bowel entrapment due to a fracture or dislocation of the spine is suspected, surgical treatment is necessary to manage the risk of complications or subsequent infection due to intestinal perforation.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal obstruction caused by small bowel entrapment within a lumbar fracture: A case report

et al. 2022

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Introduction: Intestinal obstruction associated with traumatic vertebral fracture is extremely rare. We report a case of obstructive small bowel injury caused by entrapment of the small intestine at the fracture site of the 5 th lumbar vertebra due to trauma. Case presentation: A 55-year-old man fell from a height of 4 m and visited the emergency room of a local hospital with complain of back pain. During the examination, a 5 th lumbar vertebral body fracture and left psoas muscle hematoma were observed, and the patient was admitted to the neurosurgery department for conservative treatment. The patient received conservative treatment for 2 days, but new symptoms of intestinal obstruction and fever occurred. A neurosurgeon at the hospital suspected duodenal perforation and transferred the patient to the regional trauma center for treatment. Our medical staff reviewed the patient’s symptoms and imaging data and decided to perform an emergency operation because of small bowel entrapment in the 5 th lumbar vertebrae fracture and perforation of the small intestine. We found that the small bowel, approximately 160 cm below the ligament of Treitz, was incarcerated at the 5 th lumbar vertebral fracture site. After careful manual reduction of the entrapment of the small intestine, a small bowel resection of 25 cm, including the injury site, was performed with anastomosis. Conclusion: If symptoms of intestinal obstruction are observed in patients with traumatic spinal injury, medical staff must consider the exceedingly rare possibility of bowel entrapment.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Intestinal obstruction caused by small bowel entrapment within a lumbar fracture: A case report

et al. 2022

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“…Patients with gastrointestinal damage due to blunt abdominal trauma often present with acute symptoms due to bowel rupture and/or bleeding, usually requiring emergent surgery. However, in rare cases small bowel stenosis or obstruction occurs several days or months after the trauma [1][2][3]. The underlying causes of trauma-induced intestinal stenosis include altered circulation due to mesenteric damage, direct damage to the intestinal wall and hematoma formation, and inflammatory adhesions [4].…”

Section: Discussionmentioning

confidence: 99%

Small bowel stenosis after blunt abdominal trauma: a case report

et al. 2020

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Background: Small bowel stenosis after blunt abdominal trauma is relatively rare, and progression from trauma to bowel stenosis might sometimes be delayed. Herein, we report the case of a patient who was diagnosed with small bowel stenosis relatively early and received laparoscopic surgery. Case presentation: An 18-year-old Japanese male was in a traffic accident and was urgently transported to our hospital. On arrival, he was admitted with right kidney and right adrenal injury and abdominal aortic aneurysm. On hospital day 13, he vomited during conservative treatment without surgery, and computed tomography revealed small bowel stenosis and dilatation of the oral-side small bowel. No improvement with the ileus tube occurred, and he received laparoscopic surgery on hospital day 21. Briefly, the abdominal cavity was observed with a laparoscope. The mesentery was congested, scarring around the stenotic small bowel regions was present, and three stenotic regions were observed 40-50 cm from the Treitz ligament. The patient received partial resection and anastomosis of the small bowel. The postoperative course was stable, and he was discharged on postoperative day eight. Conclusions: Most cases of bowel stenosis after abdominal trauma are irreversible and usually require surgical treatment. Therefore, small bowel stenosis should be considered in patients with abdominal symptoms after blunt abdominal trauma.

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