Mechanical small bowel obstruction following a blunt abdominal trauma: A case report. Issue 4 (December 2015)

• Record Type: Journal Article
• Authors: Zirak-Schmidt, Samira; El-Hussuna, Alaa
• Is Part Of: Annals of medicine and surgery. Volume 4:Issue 4(2015:Dec.)
• Page Start: 338
• Page End: 340
• Publication Date: 2015-12
• Subjects: Intestinal obstruction -- Ileus -- Abdominal trauma -- Adhesions -- Trauma CT; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2015.09.010
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Intestinal obstruction following abdominal trauma has previously been described. However, in most reported cases pathological finding was intestinal stenosis. Presentation of the case: A 51-year-old male was admitted after a motor vehicle accident. Initial focused abdominal sonogram for trauma and enhanced computerized tomography were normal, however there was a fracture of the tibia. Three days later, he complained of abdominal pain, constipation, and vomiting. An exploratory laparotomy showed bleeding from the omentum and mechanical small bowel obstruction due to a fibrous band. Discussion: The patient had prior abdominal surgery, but clinical and radiological findings indicate that the impact of the motor vehicle accident initiated his condition either by causing rotation of a bowel segment around the fibrous band, or by formation of a fibrous band secondary to minimal bleeding from the omentum. Conclusion: High index of suspicion of intestinal obstruction is mandatory in trauma patients presenting with complaints of abdominal pain, vomiting, and constipation despite uneventful CT scan. Highlights: A 51-year old male with a history of previous abdominal surgery admitted after trauma. The patient had an open tibia fracture but uneventful diagnostic imaging. Explorative laparotomy 3 days after showed mechanical small bowel obstruction. Fibrous adhesion's band can cause intestinal obstruction following abdominal trauma. High index of suspicion in trauma patients with abdominal pain, vomiting and constipation.