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Total intestinal obstruction due to traumatic submucosal jejunal hematoma: A case report

Samuel Amosilo Santoso Kesek1, Dikki Drajat Kusmayadi1, Kozzy2

  • 1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine Padjadjaran University/Dr Hasan Sadikin General Hospital, Bandung, Indonesia.

International Journal of Surgery Case Reports
|July 5, 2024
PubMed

Insights

Blunt abdominal trauma from bicycle handlebars can cause rare jejunal hematomas in children, leading to obstruction. Prompt CT scans and surgical intervention are vital for diagnosis and treatment of this serious injury.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Gastrointestinal Surgery

Background:

  • Blunt abdominal trauma can cause intestinal injuries, including hematomas leading to obstruction.
  • Traumatic submucosal jejunal hematomas are uncommon, particularly in pediatric patients.
  • Bicycle handlebar injuries are a recognized cause of such trauma.

Observation:

  • A 10-year-old boy experienced delayed symptoms of abdominal pain, vomiting, and obstipation after a bicycle handlebar injury.
  • Computed tomography (CT) scan revealed a submucosal jejunal hematoma causing intestinal obstruction.
  • The patient underwent exploratory laparotomy and duodenojejunostomy for treatment.

Findings:

  • Submucosal jejunal hematomas in children are rare but serious consequences of blunt abdominal trauma.
  • Delayed presentation of symptoms can complicate diagnosis, requiring a high index of suspicion.
  • CT imaging is crucial for identifying the extent of the injury and guiding management.

Implications:

  • This case highlights the importance of considering traumatic jejunal hematomas in pediatric patients with abdominal trauma, especially from bicycle injuries.
  • Early recognition and appropriate imaging, such as CT scans, are essential for timely diagnosis.
  • Surgical intervention may be required for complete intestinal obstruction, emphasizing the need for prompt management.
Abstract

Keywords:
Bicycle handlebar injuriesPediatric traumaSubmucosal jejunal hematoma

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