Small bowel obstruction due to traumatic mesenteric injury
Blunt abdominal trauma is a cause of post traumatic small bowel obstruction (PTSBO) 1. Typically, small bowel obstruction post trauma presents at least 2 weeks after the initial insult. It is thought that in this time, micro-perforations heal with fibrotic tissue, leading to stricture formation 2. It is unusual for a case of small bowel obstruction to present within only 2 days, as was the case with our patient.
Signs of small bowel obstruction in our case include:
dilated loops of small bowel
transition point from dilated small bowel to collapsed small bowel
stranding and distortion of the mesentery
poorly enhancing mucosa
The management for post-traumatic small bowel obstruction is controversial. Some reports have suggested that primary excision of the affected bowel with re-anastomosis has a good clinical outcome 3. On the other hand, there have also been small case studies where five out of six patients with PTSBO were successfully conservatively managed 4.