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Multimodality Diagnosis of Mesenteric Ischemia
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Massive rectal bleeding distant from a blunt car trauma.

E Gruden1, E Ragot, R Arienzo

  • 1Departments of General and Digestive Surgery, Louis-Mourier University-Hospital, AP-HP, Paris Diderot (Paris-7) University, 178 rue des Renouillers, Colombes cedex, France.

Gastroenterologie Clinique Et Biologique
|July 20, 2010
PubMed
Summary
This summary is machine-generated.

Seat belt use in car crashes can cause rare mesenteric trauma, including mesosigmoid hematomas leading to rectal bleeding. Prompt CT scans and surgical intervention are crucial for managing these blunt abdominal injuries.

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Area of Science:

  • Trauma Surgery
  • Abdominal Imaging
  • Road Safety

Background:

  • Motor vehicle crashes are a common cause of blunt abdominal trauma.
  • Seat belts, while crucial for safety, can paradoxically cause specific abdominal injuries.
  • Mesenteric injuries occur in up to 5% of blunt abdominal trauma cases.

Observation:

  • A rare case of rectal bleeding caused by a ruptured mesosigmoid hematoma is presented.
  • The injury was associated with blunt abdominal trauma from lap-and-sash seat belt use.
  • Emergent laparotomy revealed a mesosigmoid hematoma with a rectal perforation.

Findings:

  • The "seat belt mark" sign is a key indicator for suspecting intra-abdominal trauma.
  • CT scans are essential for diagnosing mesenteric and mesosigmoid complications in blunt trauma.
  • Surgical treatment is the primary choice for mesenteric hematomas with active intestinal bleeding.

Implications:

  • Early diagnosis via CT scan is vital when the "seat belt mark" is present.
  • Surgical intervention is necessary for unstable patients with active bleeding from mesenteric hematomas.
  • A conservative approach may be considered for stable patients, but surgical exploration is often required.