Traumatic ‘degloving’ injury to the ascending colon

Abstract

Traumatic 'degloving' injury to the ascending colon This is a case of a seldom published degloving injury to the caecum in a 21-year-old man following a motor vehicle accident. He was the restrained backseat passenger in a car that lost traction at 60 km/h and rolled three times. He was assisted out of the vehicle by the uninjured passengers and brought to hospital by ambulance. He had minimal recollection of the accident but was alert and orientated to person, place and time. He expressed pain over the anterior lower chest wall and entire abdomen. He was examined with a heart rate of 80 beats/min, temperature of 37.3 C, blood pressure of 125/61 mmHg, GCS 15 and respiratory rate of 16 breaths/min with an oxygen saturation of 99% on room air. His abdomen was generally tender, distended and guarded, with focal percussion tenderness over the right hemi-abdomen and right renal angle. He had tenderness to palpation over the lumbar spine but no sensorimotor changes in the lower limbs, genitals or pelvis. He had a 1.5-cm shallow laceration on the forehead without tenderness or bleeding. He had full range of motion in all limbs, without sensory or motor abnormalities. An eFAST scan was attempted but abandoned due to pain; however, brief views elicited free fluid in the abdomen.His admission blood tests revealed a white cell count of 16.3 × 10 9 /L (4.0-11.0 × 10 9 ), haemoglobin 149 g/L (130-175), venous lactate 3.2 mmol/L (0-1.9) and venous pH of 7.32 (7.30-7.4). Initial management included intravenous fluid resuscitation, nasal prong oxygen and analgesia. He underwent a full body

Long Segment Colon Degloving From Blunt Abdominal Trauma

“…The blood supply is lost with the compromise of the mesentery, leading to ischemia and necrosis [3,4]. Despite its severity, patients often present with vague symptoms such as abdominal tenderness or ecchymoses [3][4][5][6]. Ultrasound of the abdomen is associated with human error and it should not be the sole diagnostic method for blunt abdominal trauma and degloving of the colon [2,4].…”

“…In Table 1, we summarize literature on patients with degloving injuries, their demographics, the specific location of injury and their respective managements [3,4,6,[9][10][11][12][13][14][15][16]. Reported degloving injuries most often result after MVCs but have been found to occur after falls and crush injuries as well.…”

“…A Summary of Literature on Reported Cases of Degloving of the Colon and Their Repair Type[3,4,6,[9][10][11][12][13][14][15][16] …”