Asian Journal of Case Reports in Surgery

Evisceration of Bowel: Sequelae of High Velocity Injury

Emad Alvi *

Department of Surgery, JNMCH, AMU, India.

Wasif Mohammad Ali

Department of Surgery, JNMCH, AMU, India.

Isra Khan

Department of Radio-Diagnosis, JNMCH, AMU, India.

Imad Ali

Department of Surgery, JNMCH, AMU, India.

Manzoor Ahmad

Department of Surgery, JNMCH, AMU, India.

*Author to whom correspondence should be addressed.

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Abstract

Bowel evisceration is an uncommon finding after blunt abdominal trauma, therefore it warrants prompt action and urgent intervention in form of emergency laparotomy.

We report a young male who sustained multiple abdominal injuries due to a high impact mechanism resulting in bowel evisceration and underwent emergency laparotomy.

Case Report: In a high speed motorcycle accident a 18 year old male sustained a direct blunt injury to his abdomen which resulted in a perforation of the stomach, transection of colon, multiple mesenteric injuries and B/L pneumothorax. The abdominal wall split transversely extruding intact bowel. After resuscitation according to ATLS guidelines, patient was taken for emergency laparotomy. After 20 days in Intensive Care Unit and surgical ward, patient was discharged in a satisfactory condition.

Conclusion: High velocity blunt trauma to abdomen results in high mortality and morbidity. Blunt trauma resulting in evisceration requires prompt intervention, and the approach is tailored according to the magnitude of injury.

Keywords: Blunt trauma abdomen, damage control surgery, exploratory laparotomy, bowel perforation, pneumothorax, gastrectomy

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References

Guillen B, Cassaro S. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL); 2022. Traumatic Open Abdomen.

Arwa H. Ibrahim, Adel J. Osman, Mosab A. Alarfaj. Case report: Evisceration of abdomen after blunt trauma. International Journal of Surgery Case Reports. 2020;72:207-211.ISSN 2210-2612,

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

El-Menyar A, Parchani A, Peralta R, Zarour A, Al-Thani H, Al-Hassani A. Frequency, causes and pattern of abdominal trauma: a 4-year descriptive analysis. J. Emerg. Trauma Shock. 2015;8(4):193.

O'Rourke MC, Landis R, Burns B. Blunt Abdominal Trauma. [Updated 2023 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available:https://www.ncbi.nlm.nih.gov/books/NBK431087/

Cawich S, Islam S, Harnarayan P, Young-Pong C: Abdominal wall disruption with evisceration after blunt trauma. BMJ Case Rep; 2014. DOI:10.1136/bcr-2014-203646

Matsevych O, Koto M, Motilall S, Kumar N. The role of laparoscopy in management of stable patients with penetrating abdominal trauma and organ evisceration, J. Trauma Acute Care Surg. 2016;81(2):307–311.

Matsevych Y, Koto MZ, Motilall SR, Kumar N. The role of laparoscopy in management of stable patients with penetrating abdominal trauma and organ evisceration. Journal of Trauma and Acute Care Surgery. 2016;81(2):307-11.

Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler A, Orgill DP. For the SCARE Group, The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines, Int. J. Surg. 2018;60:132–136.

Ull C, Bensch S, Schildhauer T, Swol J. Blunt pancreatic injury in major trauma: decision-making between nonoperative and operative treatment, Case Rep. Surg. 2018; 2018:1–5.

Tomic I, Dragas M, Vasin D, Loncar Z, Fatic N, Davidovic L. Seat-Belt Abdominal Aortic Injury-Treatment Modalities. Ann Vasc Surg. 2018 Nov;53:270.e13-270.e16.

Essola B, Batamag JBB, Engbang JP, Djomo D, Ngaroua E, et al. Blunt abdominal trauma with duodenal dissection: A case report. Arch Case Rep. 2021; 5: 023-026. DOI:10.29328/journal.acr.1001051