Case report: Evisceration of abdomen after blunt trauma

Arwa H Ibrahim,Adel J Osman,Mosab A Alarfaj,Areej M Alzamil,Munirah A Abahussain,Hanan Alghamdi

doi:10.1016/j.ijscr.2020.05.037

Arwa H Ibrahim, Adel J Osman + Show 4 more

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https://doi.org/10.1016/j.ijscr.2020.05.037

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Abstract

IntroductionAbdominal evisceration is uncommon after blunt abdominal trauma; therefore, it warrants urgent laparotomy.We report a young adult male who sustained multiple injuries due to a high impact mechanism resulting in blunt abdominal injury and underwent numerous laparotomies. Case reportIn a high-speed motorcycle accident, a twenty-six-year-old male sustained a direct, blunt injury to his abdomen, which resulted in a right hemothorax, perforation of the stomach, and small bowel. Multiple mesenteric vessels tear, a retroperitoneal hematoma, liver, and pancreatic injury. The abdominal wall split transversely, extruding intact bowel. After resuscitation, according to the ATLS protocol, the patient underwent eight laparotomies for damage control. After 45 days in the Surgical Intensive Care Unit, then 11 days in the surgical ward, he was discharged in a satisfactory condition. Eight months later, he was admitted electively for ileostomy reversal, which was uneventful. ConclusionPatients with high trauma mechanisms have high mortality and morbidity rate. Blunt injury with eviscerated abdominal contents requires prompt, expeditious, and timely intervention, particularly at the initial operative intervention with damage control procedures, both prompt management and structured approach, were tailored depending in the magnitude of the injury. A multidisciplinary approach is mandatory throughout the period of treatment until recovery and rehabilitation.

Highlights

Abdominal evisceration is uncommon after blunt abdominal trauma; it warrants urgent laparotomy.We report a young adult male who sustained multiple injuries due to a high impact mechanism resulting in blunt abdominal injury and underwent numerous laparotomies
Blunt abdominal trauma resulting in gastric perforation is not the usual presentation in which the incidence of gastric rupture is very low 0.02–1.7% [7]
Duodenal rupture is extremely rare to be found after blunt abdominal trauma accounting for only 0.2% (208 patients) in a retrospective study analyzing trauma database of 103,864 patients [9] those types of duodenal injury range from intramural hematoma to a complete duodenal transection and devascularization [9]

Summary

INTRODUCTION

Abdominal evisceration is uncommon after blunt abdominal trauma; it warrants urgent laparotomy. We report a young adult male who sustained multiple injuries due to a high impact mechanism resulting in blunt abdominal injury and underwent numerous laparotomies. CASE REPORT: In a high-speed motorcycle accident, a twenty-six-year-old male sustained a direct, blunt injury to his abdomen, which resulted in a right hemothorax, perforation of the stomach, and small bowel. After resuscitation, according to the ATLS protocol, the patient underwent eight laparotomies for damage control. Blunt injury with eviscerated abdominal contents requires prompt, expeditious, and timely intervention, at the initial operative intervention with damage control procedures, both prompt management and structured approach, were tailored depending in the magnitude of the injury. A multidisciplinary approach is mandatory throughout the period of treatment until recovery and rehabilitation

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Case report

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