Sethuraman Arvinth Shivaa, Fonseca Ashley Giselle, Santolaya Jacobo Leopoldo
Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas USA.
Division of Gastroenterology, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas USA.
JPGN Rep. 2025 Mar 26;6(2):181-183. doi: 10.1002/jpr3.70019. eCollection 2025 May.
Traumatic bowel injury is an uncommon injury pattern that can have a delayed presentation after an initial trauma hospitalization and present to pediatricians with nonspecific symptoms. This syndrome is often missed and can mimic other common gastrointestinal conditions. Our case presents a previously healthy 16-year-old girl with recent trauma admission who re-presented to the hospital with a presumed superior mesenteric artery syndrome and had a mixed response to initial management. Given persistent symptoms despite standard care, subsequent management consisted of an exploratory laparotomy that led to findings of a strictured segment of the bowel that was resected and led to clinical recovery. These patients can initially present with normal imaging and have an evolving inflammatory-mediated process due to microvascular injury and abscess formation. These injuries should be included in the differential diagnosis of patients with nausea, vomiting, abdominal pain, weight loss, and fever in the setting of recent blunt abdominal trauma.
创伤性肠损伤是一种不常见的损伤模式，在初次创伤住院后可能出现延迟表现，并以非特异性症状就诊于儿科医生。这种综合征常常被漏诊，且可能类似其他常见的胃肠道疾病。我们的病例是一名此前健康的16岁女孩，近期因创伤入院，再次入院时被诊断为疑似肠系膜上动脉综合征，对初始治疗反应不一。尽管进行了标准治疗但症状持续存在，后续治疗包括剖腹探查术，术中发现一段狭窄的肠段并将其切除，最终患者临床康复。这些患者最初影像学检查可能正常，由于微血管损伤和脓肿形成，会出现一个不断演变的炎症介导过程。对于近期有腹部钝性创伤且出现恶心、呕吐、腹痛、体重减轻和发热的患者，鉴别诊断时应考虑这些损伤。
