Penetrating abdominal trauma (bowel and splenic injuries)

Case contributed by Dr Ahmed Hamdy Mhsb

Presentation

Multiple stab injuries to the left side.

Patient Data

Age: 30 years
Gender: Male
  • free intraperitoneal air noted mainly anterior to the liver surface
  • multiple deep lacerations of the spleen (grade III AAST splenic Injury)
  • large pericolic hematoma around the descending colon exerting mass effect with lumen
  • subtle adjacent colonic wall tear
  • small left hemothorax
  • right lobe of liver calcific foci (incidental)

Contrast leak from the colon at the splenic flexure, indicating a perforation at this site.

Black box outlines the site of contrast leak from bowel, indicating the site of perforation. 

Case Discussion

At surgery, a splenectomy and left colon resection with anastomosis was performed.A diaphragmatic tear was also discovered and repaired.

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