Traumatic gastric laceration with injury of splenic and celiac vessel following intentional self-harm by crashing of motor vehicle: A case report. (June 2022)

• Record Type: Journal Article
• Authors: Acharya, Shiwani Sharma; Karmacharya, Robin Man; Vaidya, Satish; Adhikari, Mahesh Mani; Upadhyay, Gaurav; Bhandari, Niroj; Bhatt, Swechha
• Is Part Of: Annals of medicine and surgery. Volume 78(2022)
• Publication Date: 2022-06
• Subjects: Abdominal injuries -- Accident and emergency department -- Case report -- Lacerations -- Splenectomy -- Vascular injuries; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103827
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Intra-abdominal injury due to blunt trauma accounts for 5–10% of all traumatic cases. It usually occurs secondary to motor vehicle collision, pedestrian injury, and falls. Typically these result in injury to solid abdominal organs–liver and spleen, hollow visceral organs, and rarely the abdominal vasculature. Blunt abdominal trauma causing concurrent injury to the hepatic branch of the celiac artery and the associated vein along with gastric laceration is a rare presentation and has a high mortality rate, thereby warranting prompt evaluation. While the initial stabilization should follow Advanced Trauma Life Support guidelines, the adherence to nonoperative management or operative care depends upon the severity of the injury and the patient's clinical status. Here, we present an unusual case of gastric and splenic laceration with damage to the hepatic branch of celiac artery, splenic artery, and the associated vein following blunt abdominal trauma in a 12-year-old child following intentional self-harm by crashing a self-inflicted motor vehicle. Despite the negative preoperative radiological finding, the case was managed successfully with the laparotomic correction of the damaged stomach segment, splenectomy, and repair of the damaged artery, and ligation of the transected vein to control hemorrhage. Highlights: Traumatic gastric and splenic laceration with injury to the hepatic branch of the celiac artery. Exploratory laparotomy reveals a concealed rent in the hepatic branch of the celiac artery causing a source of continuous blood flow. Surgical repair of the damaged viscera and artery, splenectomy, and ligation of the transected vein.