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Late small bowel obstruction after blunt abdominal trauma
D Maharaj1, A Perry, M Ramdass
1Department of Surgery, University of the West Indies, General Hospital, Port-of-Spain, Trinidad, West Indies. dalemaharaj@hotmail.com
Postgraduate Medical Journal
|February 5, 2003
Summary
Blunt abdominal trauma can rarely cause delayed small bowel obstruction due to stricture formation. This case highlights mesenteric vascular injury as a cause of such post-traumatic bowel strictures.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Vascular Surgery
Background:
- Blunt abdominal trauma with intraperitoneal injury typically presents acutely.
- Delayed small bowel obstruction can occur weeks or months after initial injury.
- Potential causes include subclinical perforation, localized ischemia, or mesenteric vascular injury.
Observation:
- A patient presented with features of small bowel obstruction long after blunt abdominal trauma.
- Imaging and surgical findings revealed a stricture in the small bowel.
- Evidence pointed towards an injury to the mesenteric vasculature as the preceding event.
Findings:
- The study supports the theory that mesenteric vascular injury can lead to delayed small bowel stricture formation.
- This mechanism explains the rare presentation of bowel obstruction following seemingly minor blunt abdominal trauma.
- Histopathological analysis confirmed vascular compromise in the affected bowel segment.
Implications:
- Understanding this mechanism is crucial for diagnosing and managing delayed complications of blunt abdominal trauma.
- It emphasizes the importance of considering vascular injury even in the absence of overt signs of perforation.
- This case contributes to the literature on the long-term consequences of mesenteric vascular trauma.