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Intestinal stenosis from mesenteric injury after blunt abdominal trauma
A I De Backer1, A M De Schepper, W Vaneerdeweg
1Department of Radiology, University of Antwerp, Universitair Ziekenhuis Antwerpen, Wilrijkstraat 10, B-2650 Edegem, Belgium.
Abstract:
We report a case in which blunt abdominal trauma resulted in injury to the mesentery with subsequent ischemic stricture of the adjacent small bowel. We present CT images at the time of trauma and 5 weeks later when clinical signs of intestinal obstruction occurred. We include images of enteroclysis and angiography of this uncommon sequela of blunt abdominal trauma. At surgery, a stenotic small bowel loop was found adjacent to a healed defect in the mesentery. Histological examination of the resected segment showed mucosal and submucosal ischemia with mucosal ulceration, mural inflammation, and fibrosis. Posttraumatic intestinal stenosis subsequent to a mesenteric tear should be included in the differential diagnosis in a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.
Insights
Blunt abdominal trauma can cause mesenteric injury leading to small bowel obstruction. This case highlights post-traumatic intestinal stenosis as a rare but important diagnosis after abdominal injury.
Area of Science:
- Gastroenterology
- Radiology
- Trauma Surgery
Background:
- Blunt abdominal trauma can cause mesenteric injuries.
- Mesenteric injuries may lead to delayed complications such as intestinal stenosis.
- Early recognition is crucial for timely intervention and improved patient outcomes.
Observation:
- A case of blunt abdominal trauma is presented.
- CT scans revealed mesenteric injury at the time of trauma and 5 weeks later.
- Clinical signs of intestinal obstruction developed 5 weeks post-trauma.
Findings:
- Enteroclysis and angiography demonstrated an uncommon sequela of blunt abdominal trauma.
- Surgery revealed a stenotic small bowel loop adjacent to a healed mesenteric defect.
- Histology confirmed mucosal and submucosal ischemia, ulceration, inflammation, and fibrosis.
Implications:
- Post-traumatic intestinal stenosis following mesenteric tears should be considered in patients with a history of blunt abdominal trauma and signs of obstruction.
- This case underscores the importance of considering delayed complications after abdominal trauma.
- Radiological and surgical evaluation are key to diagnosing and managing this rare condition.