Traumatic bowel injury

Case contributed by RMH Core Conditions

Presentation

Motor vehicle collision. Driver.

Patient Data

Age: 90
Gender: Male

Abdomen/Pelvis

Modality: CT

Pneumoperitoneum and moderate amount of intraperitoneal free fluid (water density) is in keeping with bowel perforation. There is a particularly abnormal appearing loop of small bowel that is transversely oriented across the central abdomen. This appears moderately distended, measuring 2.5 cm in maximum dimension and has internal increased density suggestive of blood. More diffuse small bowel wall thickening in the setting of hypovolaemia (collapsed IVC) suggests "shock bowel". Diffuse mesenteric stranding in keeping with mesenteric traumatic injury. Bulky left adrenal gland suspicious of haemorrhage.

Right pleural effusion. Emphysematous changes and calcified pleural plaques noted. Hiatus hernia. Moderate to severe coronary artery calcification.

Non united right L1 transverse process, a normal variation.

Case Discussion

This case demonstrates the following injuries:

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Case Information

rID: 26328
Case created: 13th Dec 2013
Last edited: 7th Mar 2016
Inclusion in quiz mode: Included

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