Rare and unexpected findings in a multitraumatized patient requiring emergency laparotomy. A case report

Andrzej Żyluk, Zbigniew Szlosser

Abstract


ABSTRACT

Multitraumatic injuries are common in an era of widespread motoring. Abdominal trauma is linked with 30–40% of these injuries. Intraabdominal bleeding caused by ruptured abdominal viscera: liver, spleen or small bowel mesentery is potentially life-threatening and, in most cases, requires immediate surgical intervention.

The paper reports the case of a patient following multitrauma, who was operated on in an emergency due to abdominal haemorrhage. During the laparotomy, apart from lesions causing 

bleeding (laceration of the mesentery and small bowel perforation), two unexpected, uncommon lesions were found: a healthy Meckel diverticulum and haematoma in the mesentery of the appendix.

The rules of diagnostics and management in typical abdominal injuries are discussed, with special attention to some rare and atypical pathologies found during the operation.


Keywords


multitrauma; intraabdominal bleeding; Meckel diverticulum; vermiform appendix

Full Text:

PDF (Język Polski)

References


Żyluk A. Obrażenia wielonarządowe. In: Żyluk A, editor. Zarys chirurgii. Podręcznik dla studentów i lekarzy w trakcie specjalizacji. Warszawa: Medipage; 2016. p. 420-8.

Schein M. Niedrożność jelita cienkiego. In: Schein M, Rogers PN, Assalia A, editors. Zdrowy rozsądek w chirurgii ostrego brzucha. Warszawa: Medmedia; 2013. p. 193-208.

Górecki W. Nagłe schorzenia brzuszne u niemowląt i dzieci. Uchyłek Meckela. In: Schein M, Rogers PN, Assalia A, editors. Zdrowy rozsądek w chirurgii ostrego brzucha. Warszawa: Medmedia; 2013. p. 334.

Ruscher KA, Fisher JN, Hughes CD, Neff S, Lerer TJ, Hight DW, et al. National trends in the surgical management of Meckel’s diverticulum. J Pediatr Surg 2011;46:893-6.

Hall JF, Stein SL. Unexpected intra-operative findings. Surg Clin North Am 2013;93:45-59.

Dunlop MG. Jelito i wyrostek robaczkowy. Uchyłek Meckela. In: Garden OJ, Bradbury AW, Forsythe JL, Parks RW, editors. Chirurgia. Podręcznik dla studentów. Wrocław: Elsevier, Urban & Partner; 2009. p. 341.

Go SJ, Sul YH, Ye JB, Kim JS. Appendiceal transection associated with seat belt restraint. Ann Surg Treat Res 2016;91(2):93-5.




DOI: https://doi.org/10.21164/pomjlifesci.257

Copyright (c) 2017 Andrzej Żyluk, Zbigniew Szlosser

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/