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Delayed small bowel obstruction after blunt abdominal trauma. A case report
I Chatzis1, A Katsourakis, G Noussios
1Surgical Department, Agios Demetrios General Hospital, Thessaloniki, Greece.
Acta Chirurgica Belgica
|December 5, 2008
Summary
Delayed small bowel obstruction can occur months after trauma due to mesenteric injury. This rare condition, post-traumatic ischemic bowel stenosis, requires clinical suspicion for accurate diagnosis and treatment.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Radiology
Background:
- Small bowel stricture and obstruction are rare but serious complications following abdominal trauma.
- Delayed presentations, occurring months after the initial injury, pose diagnostic challenges.
Observation:
- A case of subtle small bowel obstruction presented 3 months after a motor vehicle accident.
- Initial CT scans revealed retroperitoneal and mesenteric hematomas, suggesting mesenteric injury.
Findings:
- Post-traumatic ischemic bowel stenosis can result from mesenteric tears or contusions, leading to bowel wall ischemia, inflammation, and fibrosis.
- Histopathological examination of specimens revealed mesenteric tears or intramural hematomas.
Implications:
- Clinicians should maintain a high index of suspicion for post-traumatic small bowel stricture in patients with bowel obstruction weeks or years after abdominal injury.
- Early recognition and diagnosis are crucial for managing this rare but potentially severe condition, especially in cases involving seat-belt injuries.
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