Delayed presentation of traumatic sigmoid perforation accompanied by ileal devascularization due to mesentric tear in a patient with blunt abdominal trauma-a case report

Abstract

Isolated colonic injuries are unusual following blunt abdominal trauma, and often have a delayed presentation. Associated or isolated mesentric injuries of small bowel although more frequent than the former, tend to present late as well. Due to the atypical presentation, these injuries are often missed and lead to significant morbidity and mortality. We present a case of blunt abdominal trauma that presented 7 days after primary injury with fecal peritonitis leading to septic shock. Patient had a sigmoid perforation with associated mesentric tear, devascularising its corresponding bowel. Patient underwent exploratory laprotomy. A resection of perforated sigmoid colon with descending-sigmoid anastomosis along with resection of devascularised ileum and double barrel stoma were performed. Patient required intensive care in the early perioperative period. He recovered well and was discharged on post operative day 10.