Yamaji Fuminori, Fukuta Tetsuya, Ichihashi Masahiro, Mizuno Yosuke, Suzuki Keiko, Miyake Takahito, Kanda Norihide, Okada Hideshi
Gifu University Hospital, Gifu, Japan.
Department of Emergency and Disaster Medicine, Gifu University School of Medicine Graduate School of Medicine, Gifu, Gifu Prefecture, Japan.
Trauma Surg Acute Care Open. 2025 Jan 30;10(1):e001727. doi: 10.1136/tsaco-2024-001727. eCollection 2025.
Small bowel injuries are rare in trauma. Diagnosing these injuries is difficult owing to the lack of clear signs, and delays in diagnosis might increase complications and mortality. Trauma can damage the vascular endothelial glycocalyx, with syndecan-1 emerging as a marker of injury. Here, we describe two cases of small bowel injury due to traffic motor vehicle crash trauma.
The patients, one in their 40s and one teenaged, were transported to our hospital after a traffic motor vehicle crash. Both patients were wearing seat belts at the time of the motor vehicle crash, and the car's airbags deployed properly. Their vital signs were stable at admission, and non-operative treatment was selected. However, their abdominal pain did not improve, and based on posthospitalization CT reconstructive imaging, intra-abdominal hemorrhage was suspected. Surgery was performed, revealing small intestinal injuries. In both patients, a high serum syndecan-1 level in the blood test at admission was a common characteristic.
Increased serum syndecan-1 level was observed in blood tests during the initial treatment of small intestinal injuries in these patients, suggesting its potential utility in early diagnosis. However, further accumulation of cases and detailed studies are required to substantiate these results.
小肠损伤在创伤中较为罕见。由于缺乏明确的体征，诊断这些损伤较为困难，而诊断延迟可能会增加并发症和死亡率。创伤可损伤血管内皮糖萼，syndecan-1成为损伤的标志物。在此，我们描述两例因交通机动车碰撞创伤导致的小肠损伤病例。
两名患者，一名40多岁，一名青少年，在交通机动车碰撞后被送往我院。两名患者在机动车碰撞时均系着安全带，汽车安全气囊正常弹出。入院时他们的生命体征稳定，选择了非手术治疗。然而，他们的腹痛并未改善，根据住院后的CT重建影像，怀疑有腹腔内出血。进行了手术，发现小肠损伤。两名患者入院时血液检查中血清syndecan-1水平升高是共同特征。
在这些患者小肠损伤的初始治疗期间，血液检查中观察到血清syndecan-1水平升高，提示其在早期诊断中的潜在效用。然而，需要进一步积累病例并进行详细研究以证实这些结果。
