DOI: https://dx.doi.org/10.18203/2349-2902.isj20220666
Published: 2022-02-28

A rare case of isolated sigmoid colon injury in blunt trauma abdomen: a case report

V. Kopperundevi, G. Vimla, Sai Vyshnavi Y., R. Kannan

Abstract


Isolated colonic injury due to blunt abdominal trauma is very rare. Modalities of detecting colonic injuries are also very inconclusive in the background of a blunt trauma abdomen. Here we present a case of blunt trauma abdomen in a 45 year old male who sustained steering wheel injury in a road traffic accident 5 days ago and presented with symptoms and signs of peritonitis. Ultrasonography showed free fluid in the pelvis that was confirmed by contrast enhanced CT of the abdomen which revealed additional intraperitoneal air pockets with hemoperitoneum. Patient was taken up for emergency laparotomy and findings included fecal peritonitis, sigmoid colon perforation with impending transection. Peritoneal lavage with Hatmann’s procedure was done. Due to lack of a definitive diagnostic method, it is very challenging to detect such injuries and this will lead to delay in treatment and subsequently results in high morbidity and mortality.


Keywords


Blunt trauma, Sigmoid, Perforation, Hemoperitoneum, Transection

Full Text:

PDF

References


Nicholas JM, Rix EP, Easley KA, Feliciano DV, Cava RA, Ingram WL, et al. Changing patterns in the management of penetrating abdominal trauma: The more things change, the more they stay the same. J Trauma. 2003;55(6):1095-8.

Watts DD, Fakhry SM, EAST Multi-Institutional Hollow Viscus Injury Research Group. Incidence of hollow viscus injury in blunt trauma: an analysis from 275,557 trauma admissions from the east multi-institutional trial. J Trauma. 2003;54(2):289-94.

Ricciardi R, Paterson CA, Islam S, Sweeney WB, Baker SP, Counihan TC. Independent predictors of morbidity and mortality in blunt colon trauma. Am Surg. 2004;70(1):75-9.

Dauterive AH, Flancbaum L, Cox EF. Blunt intestinal trauma. A modern-day review. Ann Surg. 1985;201(2):198-203.

Hughes TM, Elton C, Hitos K. Intra-abdominal gastrointestinal tract injuries following blunt trauma: the experience of an Australian trauma centre. Injury. 2002;33(7):617-26.

Zheng YX, Chen L, Tao SF, Song P, Xu SM. Diagnosis and management of colonic injuries following blunt trauma. World J Gastroenterol. 2007;13(4):633-6.

Oztürk G, Aydınlı B, Atamanalp SS. Blunt colonic injury: a 64-case series. Ulus Travma Acil Cerrahi Derg. 2009;15(4):347-52.

Ammar AS, Khalid R, Saeed S, Naqi SA. A rare case of isolated sigmoid colon perforation in patient with blunt trauma abdomen. J Emerg Med Trauma Surg Care. 2020;7:53.