Grade V small bowel injury after blunt abdominal trauma: a case report

Authors

  • Rashid I. Arjona Bojórquez Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Isidro R. Puerto Serrano Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Aron Cervantes Sanchez Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Jonathan E. Ceseña Barrientos Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Orson R. Juan Hernandez Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Deysi L. Navarrete Espinosa Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México
  • Christian A. Salazar Quijano Department of General Surgery, Hospital General de Especialidades de Campeche, Campeche, Mexico
  • Grisell G. Garcia Catalan Department of General Surgery, Unidad Médica de Alta Especialidad IMSS #14, Veracruz, Mexico
  • Alondrea S. Polanco Llanes Department of Internal Medicine, Hospital General de Especialidades, Campeche, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20221995

Keywords:

Blunt trauma, Bucket loop, Anastomosis

Abstract

Injury of the small intestine or mesentery that requires surgical intervention is relatively uncommon, presenting less than 1% of all trauma. Unstable hemodynamically patients with peritoneal irritation signs and stable hemodynamically patients with radiological signs of intestine or mesentery lesions need an exploratory laparotomy. A 33-year-old male patient, suffered a car accident in which he had a frontal impact collision and was between two structures for 30 minutes, and rescued by the fire department. Physical examination of the abdomen presents generalized pain on palpation of moderate intensity and rebound sign. An exploratory laparotomy was performed, the findings were: hemoperitoneum of 1500 ml was found, lesion in the bucket loop of 1.2 meters, 1.8 meters from the Treitz angle and 70 cm from the ileocecal valve. We managed with drainage, vascular control, resection of the devascularized intestinal loop and small bowel shotgun stoma were. The patient was transferred to the intensive care unit for hemodynamic management and a second look was performed 5 days after surgery where cavity lavage, stoma dismantling and end-to-end anastomosis of the small intestine in two planes were performed. On post-operative day 7 drains were removed, and the patient was discharged from the surgical service due to improvement, without complications. We recommend a multidisciplinary approach to patients with polytrauma, since they lead to a better and faster recovery, in the same way it allows us to detect and treat any abnormality that impacts the quality of life of patients early.

Author Biographies

Rashid I. Arjona Bojórquez, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Resident

Isidro R. Puerto Serrano, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Surgeon

 

Aron Cervantes Sanchez, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Resident

Jonathan E. Ceseña Barrientos, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Resident

Orson R. Juan Hernandez, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Resident

Deysi L. Navarrete Espinosa, Department of General Surgery, Hospital Ignacio Garcia Tellez IMSS T-1, Mérida, Yucatán, México

General Surgery Department

Resident

Christian A. Salazar Quijano, Department of General Surgery, Hospital General de Especialidades de Campeche, Campeche, Mexico

General Surgery Department

Resident

Grisell G. Garcia Catalan, Department of General Surgery, Unidad Médica de Alta Especialidad IMSS #14, Veracruz, Mexico

General Surgery Department

Resident

Alondrea S. Polanco Llanes, Department of Internal Medicine, Hospital General de Especialidades, Campeche, Mexico

Internal Medicine Department

Resident

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Published

2022-07-27

How to Cite

Arjona Bojórquez, R. I., Puerto Serrano, I. R., Cervantes Sanchez, A., Ceseña Barrientos, J. E., Juan Hernandez, O. R., Navarrete Espinosa, D. L., Salazar Quijano, C. A., Garcia Catalan, G. G., & Polanco Llanes, A. S. (2022). Grade V small bowel injury after blunt abdominal trauma: a case report. International Journal of Research in Medical Sciences, 10(8), 1778–1781. https://doi.org/10.18203/2320-6012.ijrms20221995

Issue

Section

Case Reports