George Nicholas H, Baldi Charles A, Tonascia James M, Moayedi Siamak
University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
Clin Pract Cases Emerg Med. 2020 Nov;4(4):620-622. doi: 10.5811/cpcem.2020.9.47034.
Bowel obstruction is a rare but well reported complication of blunt abdominal trauma (BAT). Obstruction is most often seen acutely caused by bowel wall hematomas and chronically as a result of post-traumatic strictures. Here, we present a novel case of BAT causing a subacute obstructing bowel wall hematoma.
A healthy, 32-year-old male presented to our emergency department with three days of nausea and vomiting. Chart review revealed he had been seen two weeks prior after a high-speed motor vehicle collision. During that initial visit, the patient had a benign abdominal exam and was discharged without imaging. On this return visit, the patient was found to have a large, obstructing colonic hematoma.
Because emergency physicians care for patients in both the acute and subacute phases of trauma, clinicians should recognize the more subtle sequelae of BAT.
肠梗阻是钝性腹部创伤(BAT)一种罕见但有充分报道的并发症。梗阻最常急性见于肠壁血肿,慢性则是创伤后狭窄的结果。在此,我们报告一例由BAT导致亚急性梗阻性肠壁血肿的新病例。
一名32岁健康男性因三天的恶心和呕吐就诊于我院急诊科。病历回顾显示,他在两周前发生高速机动车碰撞后前来就诊。在初次就诊时,患者腹部检查正常,未行影像学检查即出院。此次复诊时,发现患者有一个巨大的梗阻性结肠血肿。
由于急诊医生在创伤的急性期和亚急性期都要诊治患者,临床医生应认识到BAT更隐匿的后遗症。