[When a multiple trauma complains about abdominal pains six weeks after the fall. . ]

Area of Science:

• Medical Case Report
• Trauma Surgery
• Gastroenterology

Background:

• Multiple trauma and subsequent immobilization present diagnostic challenges.
• Abdominal complications in trauma patients require careful evaluation.
• Long-term immobilization is a risk factor for various medical conditions.

Observation:

• An 18-year-old patient with paraplegia post-multiple trauma experienced abdominal pain, nausea, and vomiting.
• Diagnoses included esophagitis, urolithiasis (kidney stones), and acalculous cholecystitis (gallbladder inflammation without stones).
• The patient also had hypercalcemia, a urinary tract infection with Enterobacter Cloacae, and a large, branching (coralliform) kidney stone.

Findings:

• This case highlights two infrequent abdominal complications of multiple trauma with immobilization: acalculous cholecystitis and complex urolithiasis.
• Hypercalcemia and Enterobacter Cloacae bacteriuria were associated with the kidney stone formation.
• The abdominal symptoms in this immobilized trauma patient were potentially misleading.

Implications:

• Physicians must consider rare abdominal complications in immobilized trauma patients.
• Early recognition of acalculous cholecystitis and complex urolithiasis is crucial for effective management.
• This case underscores the importance of a comprehensive diagnostic approach in patients with prolonged immobility after trauma.