A case of bowel perforation due to traumatic hernia at a pelvic fracture site: a case report and review of the literature

BMC Surgery

Case Report

Ryota Tanaka¹  Kenji Sugano¹  Takahiro Toyokawa¹  Ryosuke Amano¹  Kiyoshi Maeda¹  Hiroaki Tanaka¹  Sadaaki Yamazoe¹  Masaichi Ohira¹  Masatsune Shibutani¹  Hiroshi Ohtani¹  Tatsuro Tamura¹  Tetsuro Ikeya¹  Kazuya Muguruma¹  Yasuhito Iseki¹  Naoshi Kubo¹  Hisashi Nagahara¹  Kenjiro Kimura¹  Kosei Hirakawa¹  Katsunobu Sakurai¹ 

[1] Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka, Japan;

关键词: Bowel perforation;    Traumatic hernia;    Pelvic fracture;    Emergency operation;   

DOI  :  10.1186/s12893-017-0278-y

 received in 2016-12-22, accepted in 2017-07-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCommon complications of pelvic fractures include visceral injury, large-volume hemorrhage, genitourinary injury, rectal injury, and pulmonary embolism. On the other hand, traumatic hernia is a rare complication, especially in association with pelvic fractures. We report a case of bowel perforation due to traumatic hernia at a pelvic fracture site.Case presentationA 65-year-old female was presented at our hospital for further examination and treatment of ileus. She was diagnosed with bowel perforation due to traumatic hernia at a pelvic fracture site, and an emergency operation was thus immediately performed. We performed segmental jejunum resection and constructed jejunostomy, and the iliac bone fracture was fixed with four pins. In the postoperative course, she received antibiotics and vasopressors for septic shock. However, there was no need for either a ventilator, dialysis or admission to the ICU. At seven days after the operation, a residual abscess was detected in the pouch of Douglas. We performed percutaneous drainage (Clavien-Dindo IIIa) and jejunostomy closedown 35 days after the first operation. The postoperative course was without complication, but she received rehabilitation until she was able to walk unaided. She was discharged 64 days after the first operation.ConclusionThe occurrence of traumatic hernia is rare, especially in association with pelvic fractures. Although its rarity, traumatic hernia follows a severe course. Thus, proper diagnosis and effective treatment are necessary. Surgeons treating patients with pelvic injuries should consider the possibility of any complications and perform a work-up examination in order to achieve an accurate diagnosis at an earlier time point.

【 授权许可】

CC BY   
© The Author(s). 2017