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Case Report
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| Missed mesenteric injury in blunt abdominal trauma: A potentially lethal error | ||||||
| Victor Kong1, John Burce2 George Oosthuizen3, Grant Laing2, Damian Clarke3 | ||||||
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1MBChB, Surgical Registrar, Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, Edendale Hospital, Pietermaritzburg, KwaZulu Natal, South Africa.
2FCS(SA), Consultant Trauma Surgeon, Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, Edendale Hospital, Pietermaritzburg, KwaZulu Natal, South Africa. 3FCS(SA), Senior Consultant Trauma Surgeon, Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, Edendale Hospital, Pietermaritzburg, KwaZulu Natal, South Africa. | ||||||
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| How to cite this article: |
| Kong V, Burce J, Oosthuizen G, Laing G, Clarke D. Missed mesenteric injury in blunt abdominal trauma: A potentially lethal error. International Journal of Case Reports and Images 2013;4(7):376–379. |
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Abstract
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Introduction:
Mesenteric injury following blunt abdominal trauma is uncommon. Delay in diagnosis is unfortunately common due to its subtle clinical presentation and is associated with significant morbidity and mortality.
Case Report: We present a case of a 35-year-old male who was discharged home with a missed mesenteric injury. The initial computed tomography scan of the abdomen and pelvis was normal. He re-presented acutely with small bowel infarction. Conclusion: Although computed tomography is the current gold standard of investigation, a very small proportion of injuries that require surgical intervention will invariably be missed. This case highlights several pitfalls in evaluation of these patients. Clinicians must always be vigilant of such injury despite normal radiological studies. A sufficient period of observation post injury should be considered in circumstances where the possibility of mesenteric injury is increased. Such circumstances include lack of seat belt usage, high-speed impact and deceleration injury. | |
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Keywords:
Mesentery, Trauma, Missed injuries, Blunt
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Author Contributions
Victor Kong – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published John Burce – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published George Oosthuizen – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Grant Laing – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Damian Clarke – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Victor Kong et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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